CRICOS Provider No. 00300K (NT/VIC) | CRICOS Provider No. 003286A (NSW) – Updated September 2019

International Scholarship Referee Report Form

This form is to be used by an academic or professional referee for an international student wishing to apply for an undergraduate or postgraduate coursework scholarship at CDU. It is essential that ALL sections are completed carefully.

APPLICANT DETAILS – to be completed by the applicant

Title Mr Mrs Ms Miss Other ________________

Family Name

Given Name(s)

Date of Birth (DD/MM/YYYY)

/ / Studylink Application Number

REFEREE DETAILS – to be completed by the referee

Title Mr Mrs Ms Miss Other ________________

Family Name

Given Name(s)

Position/Title Institution/ Workplace

Address

Contact Number Email Address

Relationship to applicant

How long have you known the applicant?

REFEREE REPORT– to be completed by the referee Please comment on the applicant’s academic strength

CRICOS Provider No. 00300K (NT/VIC) | CRICOS Provider No. 003286A (NSW) – Updated September 2019

Please comment on the applicant’s capabilities and personal qualities

Please comment on the applicant’s passion for innovation and creativity

Please comment on the applicant’s leadership abilities in their academic, work or personal life

DECLARATION BY THE REFEREE

• I declare that the information I have provided is true and correct

Signature Date (DD/MM/YYYY) / /

Instructions for the applicant: Please submit the completed referee report form together with your scholarship application when applying to study a course with CDU