Yong Loo Lin School of Medicine

Division of Graduate Medical Studies

Master of Science (Speech and Language Pathology)
(January 2021 Intake)

ACADEMIC REFEREE’S REPORT FORM

NCE

To the Applicant (Section 1)

MODE OF SUBMISSION:

ONLINE (GDA2 System)

INPUT and ASSIGN TWO Referee Names (one academic and another employment related) in the
GDA2 system which will trigger notification emails to the respective referees to complete online.
Monitor the system to ensure Referee submits the report within three weeks of receiving
notification.

OR

EMAIL

If referee has difficulty submitting online via GDA2 system, applicant is to complete Section 1 of this
form, forward to referee to submit the completed referee report form directly to Ms. Mani at email
address: entmp@nus.edu.sg.

Name of Applicant: _______________________________________________________________________

[UNDERLINE Surname / Family Name]

Referee’s Particulars

Name of Referee: _____________________________________Designation: ______________________

Name of Institution/Organisation: _________________________________________________________

Address of Institution/Organisation: ________________________________________________________

____________________________________________________________________________________

Email Address: _____________________________ Contact Number: ____________________________

To the Referee (Section 2) CONFIDENTIAL
The above-named applicant is applying for admission to National University of Singapore to undertake a two-
year intensive course of study leading to a professional practice degree of Master of Science (Speech and
Language Pathology) and has given your name as a referee. Please complete this form (Section 2) and email
to entmp@nus.edu.sg.

Thank you for your time and effort. Please be assured that any information you provide will be treated as
confidential. We would appreciate your candid comments.

1. How long have you known the applicant and in what capacity/context? (Please use separate sheet where
necessary)

2. How would you rate the applicant with his/her peers or colleagues at a similar (academic/career) level?

Excellent (Top 5%)

Very Good (Top 10%)

Good (Top 25%)

Average (Top 50%)

Below Average (Bottom 50%)

Unable to Judge

3. How many students/employees, and at which level, is the applicant being compared with?

Among undergraduate students. (Value ranges from 0 to 1000)

Among graduate students (Value ranges from 0 to 1000)

Among employees (Value ranges from 0 to 1000)

4. How would you rate the applicant on the following dimensions? (tick appropriate box)

2
 Unable Below Very
Average Good Excellent
to Judge Average Good

(1) Intellectual Ability

Originality/Creative
(2)
Problem Solving

(3) Motivation

Organisation & Time

(4)
Management
Quality of Oral Expression
(5)
(English)
Quality of Written
(6)
Expression (English)

(7) Integrity

Unable Below Very

to Judge Average Good Excellent
Average Good
Commitment to
(8)
Public/Community Service
5.
(9) Teamwork

(10) Potential to Excel

(11) Competency & Efficiency

(12) Energy & Drive

(13) Leadership Qualities

(14) Maturity

(15) Cross-Cultural Awareness

Please comment on the applicant’s academic ability and general suitability to undertake the proposed
programme of study, and any other information (e.g. weaknesses, evidence of character, values, and any
special talent or quality), which you consider to be relevant to the application. Please use separate sheet
where necessary.

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6. Recommendation (Please select the appropriate box).

(a) I strongly recommend that the applicant be admitted into the programme.

(b) I recommend that the applicant be admitted into the programme.

(c) I recommend with reservations that the applicant be admitted into the programme.

(d) I do not recommend that the applicant be admitted into the programme.

___________________________________ ________________________
Signature of Referee Date