Australia Awards

ENDEAVOUR AWARDS

Referee Report
2012
Please note that if referees return their reports directly to DEEWR they need to return their forms at least 7 days
before the closing date to allow the Endeavour Awards Team sufficient time to process and attach the report to your
online application.
Please complete all sections of this report and return it to either:
a. The applicant who will include it with their application
b. The Department of Employment and Workplace Relations (DEEWR) at endeavour.refereereports@deewr.gov.au.
Reports submitted by email directly to DEEWR will receive an automated response confirming receipt.
Reports received after the closing date will not considered.
Reports returned directly to DEEWR will be treated as confidential and will only be made available to the Endeavour
Awards Selection Panel and the administrators.
Referees may be contacted by the Selection Panel during the selection process.

1. Applicant Details

Title: Gender: Male Female

Family Name: First Name(s):

The Endeavour Award category the applicant is applying for:

Application ID:
(If known)

2. Referee Details

Title:

Family Name: First Name(s):

Position Held: Organisation:

Business Phone: + Fax: +

(Please include country and area codes) (Please include country and area codes)

Email:

Postal Address
Address Line 1:

Address Line 2:

City/Suburb: State/Province:

Postcode: Country:

What is your relationship to the applicant How long have you known the applicant

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Endeavour Awards Referee Report
Main Round closing date: 31 July 2009
Second Round closing date: 31 January 2010 20120
201
3. Selection Criteria
Please evaluate the applicant against the below criteria.
Unable to
Excellent Good Average Poor comment
Academic/Professional achievement

Leadership qualities

Personal integrity

Communication skills

Resourcefulness and initiative

Prime
Emotional maturity

Adaptability to new situations

Potential for future contribution in field of study

In no more than 300 words please expand on your evaluation and give reasons why, in your opinion, the applicant should be
considered for an Endeavour Award. Please include your comments on:
• The applicant’s suitability to undertake the proposed activity at the host university; and
• The benefits of the proposed program for the applicant’s home and host country.

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Signature Date (dd/mm/yyyy)

Print Form

* By typing your name into this box, it is considered that you have signed this form and all the information is true and correct
(An electronic signature is not required).

Privacy Notice
The Australian Government Department of Education, Employment and Workplace Relations (DEEWR) is bound by the provisions of the Privacy Act 1988
(Privacy Act). Section 14 of the Privacy Act contains the Information Privacy Principles (IPPs), which prescribe the rules for handling personal information.
Information collected in this form will be used by DEEWR for the following purposes (‘the purposes’):
a. administering the Endeavour Awards;
b. assessing applications;
c. promoting the Endeavour Awards, including in promotional material, information and publications, including on-line; and
d. to congratulate successful recipients and/or invite the successful award recipients to functions and events held in Australia and overseas.

DEEWR may disclose personal information provided to DEEWR in relation to applications under the Endeavour Awards program:
• to Australian Government departments and agencies;
• to Australian Parliamentary members and committees;
• to DEEWR’s contractors and agents; and
• in publicly available promotional material, information and publications, including on-line to be used for the purposes listed above.

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