Confidential Referee Form

Name of applicant (required)

Address of applicant (required)

Year application for (required)

Full yearSemester 1Semester 2

Referee Name (required)

Referee email address (required)

How long have you known this student?

In what capacity have you known them?

How do you rate the student on the following (please check one column for each category):

	Outstanding	Good	Average	Could be better	Poor	Unable to comment
Academic	Outstanding	Good	Average	Could be better	Poor	Unable to comment
Application to study	Outstanding	Good	Average	Could be better	Poor	Unable to comment
Verbal Expression	Outstanding	Good	Average	Could be better	Poor	Unable to comment
Written Expression	Outstanding	Good	Average	Could be better	Poor	Unable to comment
Leadership qualities	Outstanding	Good	Average	Could be better	Poor	Unable to comment
Organisational	Outstanding	Good	Average	Could be better	Poor	Unable to comment
Initiative	Outstanding	Good	Average	Could be better	Poor	Unable to comment
Social Skills	Outstanding	Good	Average	Could be better	Poor	Unable to comment
Community	Outstanding	Good	Average	Could be better	Poor	Unable to comment
Consideration	Outstanding	Good	Average	Could be better	Poor	Unable to comment
Moral qualities	Outstanding	Good	Average	Could be better	Poor	Unable to comment
Religious	Outstanding	Good	Average	Could be better	Poor	Unable to comment
Common sense	Outstanding	Good	Average	Could be better	Poor	Unable to comment
Overall character	Outstanding	Good	Average	Could be better	Poor	Unable to comment

Please comment on any matter you feel is relevant to this application.

Attach an additional page(s) if required:

Relevant family history:

Date

By ticking this box, I certify that I am digitally signing this form.

Academic	OutstandingGoodAverageCould be betterPoorUnable to comment
Application to study	OutstandingGoodAverageCould be betterPoorUnable to comment
Verbal Expression	OutstandingGoodAverageCould be betterPoorUnable to comment
Written Expression
Leadership qualities	OutstandingGoodAverageCould be betterPoorUnable to comment
Organisational	OutstandingGoodAverageCould be betterPoorUnable to comment
Initiative	OutstandingGoodAverageCould be betterPoorUnable to comment
Social Skills	OutstandingGoodAverageCould be betterPoorUnable to comment
Community	OutstandingGoodAverageCould be betterPoorUnable to comment
Consideration	OutstandingGoodAverageCould be betterPoorUnable to comment
Moral qualities	OutstandingGoodAverageCould be betterPoorUnable to comment
Religious	OutstandingGoodAverageCould be betterPoorUnable to comment
Common sense	OutstandingGoodAverageCould be betterPoorUnable to comment
Overall character	OutstandingGoodAverageCould be betterPoorUnable to comment