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Last name MUN# (if known) SECTION 2: REFEREE INFORMATION Mailing address
Name Title or rank (e.g. , Associate Professor) Institutional email address (e.g. , jdoe@mun.ca) Phone number (e.g. , (709) 555-5555)
SECTION 3: REFEREE REPORT How long have you known the applicant, and in what capacity? What university courses have you taught the applicant?
Please rank the applicant using the scale below using students from the last five years as a comparison group. Top 5% Intellectual ability Background preparation Originality and initiative Industry and perseverance Interpersonal skills Ability to work independently Ability to communicate in English (oral) Ability to communicate in English (written) Top 10% Top 25% Top 50% Bottom 50% Inability to observe
This applicant is
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I have read and agree with the above declaration. Type full name Date (DD/MM/YYYY)
Memorial University protects your privacy and maintains the confidentiality of your personal information. The information requested in this form is collected under the general authority of the Memorial University Act (RSNL1990CHAPTERM-7). It is required for the processing of your application and for administrative purposes of the School of Graduate Studies. If you have any questions about the collection and use of this information, please contact the Graduate Enrolment Manager at 864-2445 or at sgs@mun.ca SGS-09-01D Page 2 of 2