RESEARCH DEGREE APPLICATION - REFEREE’S REPORT

SECTION A - TO BE COMPLETED BY THE APPLICANT

Instructions: To check boxes using Microsoft Word, double click the desired box and select ‘Checked’ under the heading ‘Default Value’.

APPLICANT’S PERSONAL DETAILS

Title – Mr. Mrs. Miss Ms Other Email Address

(BH)
Given Name(s) Phone Number

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

COURSE DETAILS

Course Code Course Name

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

SECTION B - TO BE COMPLETED BY THE REFEREE

REFEREE’S PERSONAL DETAILS

Title – Mr. Mrs. Miss Ms Other Email Address

Given Name(s) Phone Numbers (BH)

Family Name (AH)

Organisation (M)

Position Title

REPORT

Please comment on the applicant’s research proposal and research ability. You may wish to be more specific and address the
following criteria when commenting on the applicant’s 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).

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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 applicant’s 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 applicant’s 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 applicant’s 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 HDR Support by the closing
date 30 September.

Please forward the report directly to:

HDR Support T (02) 6206 8370 (within Australia) or (T) +61 2 6206 8370 (from outside Australia)
Graduate Research E hdrsupport@canberra.edu.au
University of Canberra
Bruce, ACT 2601

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

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