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					             ACADEMIC REFEREE’S REPORT


Please type or print in black biro or ink
FOR THE APPLICANT:                          FOR THE REFEREE:
Complete section A and pass the form to     Complete section B and send to
a person whom you wish to act as your       The Secretary
academic referee. This person should be     Australian Wool Education Trust
a senior academic conversant with your      C/- AWTA Ltd
most recent academic studies                PO Box 240
                                            NTH MELBOURNE VIC 3051

Section A (to be completed by applicant)
Title (Mr, Mrs, Miss, Ms)

Family Name

Given Names

Postal address

Suburb/Town

Postcode

Telephone

Email

Proposed course

School/department/university
Section B (to be completed by referee)

Title (Dr, Mr, Mrs, Miss, Ms)
Family Name
Given Names
Position
Postal address
Suburb/Town
Postcode
Telephone
Facximile
Email
Based on the quality of completed work, the applicant is regarded as having a record
that is:

[ ] Outstanding      [ ] Very good       [ ] Good      [ ] Moderate         [ ] Poor

Based on the applicant’s overall performance and potential for the proposed course,
the degree of support I give the applicant is:

[ ] Unreserved       [ ] Strong          [ ] Fairly Strong   [ ] Moderate      [ ] Nil

Please provide written justification to the degree of support given to the applicant
(including any comments on ability to meet deadlines, which will assist in assessing
the applicant).
Referees Signature                                             Date

Please tick one of the following boxes:

[ ]   I wish this report to remain confidential

[ ]   I am willing for this report to be revealed to the applicant on request

				
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posted:2/23/2012
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