SECTION A - TO BE COMPLETED BY THE APPLICANT

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Faculty of Business, Government and Law applicants must check the How to Apply Webpage for available start dates.

APPLICANTS PERSONAL DETAILS

Title Mr. Mrs. Miss Ms Other Email Address

(BH)

Given Name(s) Phone Number

DD / MM / YYYY
Family Name Gender Male Female Date of Birth

COURSE DETAILS

Course Code Course Name

(e.g. 246AA) (e.g. Doctor of Philosophy in Communication)

SECTION A - TO BE COMPLETED BY THE REFEREE

REFEREES PERSONAL DETAILS

Title Mr. Mrs. Miss Ms Other Email Address

(BH)
Given Name(s) Phone Numbers
(AH)
Family Name
(M)
Organisation

Position Title

REPORT

Please comment on the applicants research proposal and research ability. You may wish to be more specific and address the following criteria when
commenting on the applicants academic and research potential: capacity for originality, research ability or potential, capacity for making critical
judgements, ability to manage a project and quality of verbal and written communication in general (please attached a separate sheet if more space
is needed).

Updated on 23/2/2012 Created by Research Students Office

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HONOURS AWARD RESULT
Please indicate actual or predicted final honours award result
Not Applicable or
Applicable - please specify award
Actual result Predicted result

PAST ACADEMIC RECORD

Based on the applicants overall performance and quality of completed work, the applicant is seen as having an academic record achievement
that is:
Outstanding Very Good Good Average Poor

PAST PROFESSIONAL RECORD

Based on the applicants overall performance and quality of completed work, the applicant is seen as having a record of professional achievement
that is:
Outstanding Very Good Good Average Poor

RESEARCH POTENTIAL
Please indicate the applicants potential to perform at the level of the course they are applying for:
Outstanding Very Good Good Average Poor

SCHOLARSHIP RANKING
Please rank the applicant in terms of academic standing and/or aptitude to undertake research, in the top:
5% 10% 25% 50%

Signature Date DD / MM / YYYY

Thank you for completing this confidential report. Please keep a copy for your records.

Please Note: Referee Reports accompanying a degree and scholarship application must be submitted to the Research Students Office by
the closing date 31 October.

Please forward the report directly to:

Research Students Office T (02) 6201 5199 (within Australia) or (T) +61 2 6201 5199 (from outside Australia)
Student Administration F (02) 6201 5391
Updated on 23/2/2012 Created by Research Students Office
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University of Canberra E research.admissions@canberra.edu.au
Bruce, ACT 2601

This form may be accessed through a Freedom of Information application.

Updated on 23/2/2012 Created by Research Students Office

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