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CONFIDENTIAL Not to be returned to the applicant


FOR THE REFEREE: You are invited to act as an academic referee by the applicant below. You are invited to provide these comments in confidence. The contents of your report will be treated in the strictest confidence by the University and will only be used for the purpose of considering the applicant for a Postgraduate Research Award at CQUniversity. Please return the completed form by the requisite closing date ____ ____ (applicant to insert required date). Reports may be faxed but originals must be forwarded by mail immediately afterwards. Reports that are sent via email will not be accepted. Please write in BLOCK letters using a black pen or TYPE 1 APPLICANTS DETAILS

Family name Given names Program applied for/currently enrolled in


Name of referee Title/position Institutional name and address

To your knowledge please specify the program currently, or most recently, undertaken by the applicant.

Where known, please provide the actual or predicted final examination result for the program specified above (where appropriate, specify level of Honours).

What proportion (%), if any, of the program is research-based? 0-24 25-49 50-74 75-100
CRICOS Provider Codes: QLD 00219C, NSW 01315F, VIC 01624D JN10-0083 Ver 3 Page 1 of 3

Please rate the applicants performance in the areas listed below in relation to all other Masters/Doctoral (circle appropria te) candidates you have known (please tick appropriate column). Performance AREA Knowledge of own discipline Ability to express ideas Command of research techniques Critical ability Initiative and motivation Ability to plan Perseverance in pursuing aims Predicted performance in the proposed course If the applicants first language is not English Do you consider that the applicant has the English language skills to undertake the proposed course? Please rate the applicants knowledge of English (tick appropriate column) Proficiency Skill Reading Speaking Writing Poor Average Good Yes No Unknown Poor Bottom 40% Average Top 60% Good Top 25% Very Good Top 10% Outstanding Top 2% Office use only

Print Name (Surname, Title, First Initial) Signature (Referee) Return to: Manager (Research Higher Degrees) Office of Research CQUniversity Australia Bldg 32, Bruce Highway Rockhampton Queensland 4702 Date


Phone: Fax: Email:

07 4923 2602 07 4923 2600

CRICOS Provider Codes: QLD 00219C, NSW 01315F, VIC 01624D

JN10-0083 Ver 3

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Additional comments If you wish to clarify any of the statements in this report, or add any comments which you think may assist in assessing the applicant, please use the space below (attach a separate sheet if necessary).

CRICOS Provider Codes: QLD 00219C, NSW 01315F, VIC 01624D

JN10-0083 Ver 3

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