EXAM

PLE1. APPLICANT DETAILSTitle:First Name: Last Name:

The Endeavour category the applicant is applying for:

Application ID:(If known)

2. REFEREE DETAILS

Title:

First Name: Last Name:

Position Held: Organisation:

Phone: + Mobile:

(Please include country and area codes)

Email:

Postal Address

Address Line 1:

Address Line 2:

City/Suburb: State/Province:

Postcode: Country:

Relationship to applicant Length of relationship

Years Months

3. APPLICANT EVALUATION

Please evaluate the applicant against the criteria below, in terms of your experience. (Example: Top 5% = Excellent, Top 10% = Very Good, etc.)

Poor Average Good Very Good ExcellentUnable to comment

Academic/professional achievement

Leadership qualities

Personal integrity

Capacity to communicate and relate well to others

Resourcefulness and initiative

Emotional maturity

Adaptability to new situations

Potential for future contribution in field of study

1 of 2

The selection process for the Endeavour Scholarships and Fellowships are merit-based and referee reports do not guarantee an offer.

Referee reports received after the closing date will not be considered.

Reports returned directly to the department will be treated as confidential and will only be made available to the selection panel and administrators.

Referees may be contacted by the selection panel during the selection process.

Endeavour Referee Report 2016Endeavour Referee Report The selection process for the Endeavour Scholarships and Fellowships are merit-based and referee reports do not guarantee

an offer. Referee reports received after the closing date will not be considered. Reports returned directly to the department will be treated as confidential and will only be made available to the selection

panel and administrators. Referees may be contacted by the selection panel during the selection process.

Title:

First Name: Last Name:

The Endeavour category the applicant is applying for:

Application ID:(If known)

Title:

First Name: Last Name:

Position Held: Organisation:

Phone: + Mobile: (Please include country and area codes)

Email:

Postal AddressAddress Line 1:

Address Line 2:

City/Suburb: State/Province:

Postcode: County:

Relationship to applicant Length of relationship

Years Months

Please evaluate the applicant against the criteria below, in terms of your experience.(Example: Top 5% = Excellent, Top 10% = Very Good, etc.)

Unable toPoor Average Good Very Good Excellent comment

Academic/professional achievement

Leadership qualities

Personal integrity

Capacity to communicate and relate well to others

Resourcefulness and initiative

Emotional maturity

Adaptability to new situations

Potential for future contribution in field of study1 of 2

1. APPLICANT DETAILS

2. REFEREE DETAILS

3. APPLICANT EVALUATION

Mr

Hiro Suzuki

Endeavour Research Fellowship

ERF_PDR_134977_2015

Professor

Tatsuke Yamada

Dean, Department of Engineering Hitotsubashi University

81 323 196 1347 81 323 186 5543

T.Yamada@hitotsubashi.ac.jp

2-1 Naka

Kunitachi

Tokyo Tokyo Prefecture

186-8601 Japan

Current supervisor 2 3

EXAM

PLE

4. APPLICANT SUITABILITY

Expand on your evaluation and provide reasons why, in your opinion, the applicant should be considered for an EndeavourScholarship or Fellowship. Include in your comments: The applicants suitability to undertake the proposed program at the nominated organisation; and The benefits of the proposed program for the applicants home and host country (maximum 300 words).

In order to successfully complete their proposed program, what further development does the applicant require (maximum 300 words).

Signature Date (dd/mm/yyyy)

* 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 Act 1988

The department and its contractors are bound by the provisions of the Privacy Act 1988 (Privacy Act). Schedule 1 of the Privacy Act outlines the Australian Privacy Principles (APPs), which prescribe the rules for handling personal information, including sensitive information.

Personal information (including sensitive information) provided to the department in relation to applications under the Endeavour Scholarships and Fellowships will only be used by the department for the following purposes (the Purposes): assessing applications, and administering the Endeavour Scholarships and Fellowships.

The department may disclose personal information it holds in relation to applications under the Endeavour Scholarships and Fellowships for the Purposes listed above to the following recipients: Australian Government Departments and agencies, including but not limited to Austrade, the Department of Foreign Affairs and Trade,

the Department of Immigration and Border Protection, the Australian Federal Police and the Department of Prime Minister and Cabinet Australian Parliamentarians and Parliamentary committees, and the departments contractors and agents located in Australia and/or overseas.

By completing and submitting this form, you agree that APP 8.1 will not apply in the event that your Personal Information is disclosed by the department to an individual or party located overseas. You also understand that an individual or party located overseas will not be accountable under the Privacy Act and as a result you will not be able to seek redress under the Privacy Act for any privacy breaches committed by the individual or parties located overseas.

For information on the departments privacy policy, including information on how the department handles personal information, how someone can access or correct personal information, or how to make a complaint, go to www.education.gov.au/privacy or request a copy of the privacy policy from privacy@education.gov.au.

Endeavour Referee Report

I believe Hiro Suzuki should be considered for an Endeavour Research Fellowship because.....

In my experience as Hiro Suzuki's PhD supervisor.....

Tatsuke Yamada 10/06/2016