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Breast Cancer Campaign referee report form

VIEWS: 8 PAGES: 4

  • pg 1
									                Doctoral Research Scholarship – Referees in confidence


INSTRUCTIONS FOR SUBMISSION:

Please submit either hard copies OR an electronic copy as indicated below.

Hard copy:
Post 5 x copies of report (including signature page) in a sealed envelope to the applicant, so that
the applicant can submit the report by the due date along with their other application paperwork.

Electronic:
Please insert digital signature or sign a hard copy of this page and then covert to PDF. Email to
research@nbcf.org.au

Referees will only complete the section particular to them e.g. a referee advised by the applicant
that they are “Referee 1” will only complete the section titled “Applicant assessment – detailed
comments - completed by Referee 1”.




                                             Page 1 of 4
        Applicant assessment – detailed comments - completed by Referee 1 only

Definition of Referee 1:
Intended Supervisor
Each applicant for a Scholarship should arrange for this report form to be completed by the
intended supervisor (without which the application is deemed ineligible). The referee should
forward their report in a sealed envelope to the applicant, so that the applicant can submit the
report with the application by the due date. Alternatively, email their report to
research@nbcf.org.au by the due date.

Please address all headings outlined below. Your comments can extend onto additional pages.

Name of applicant:
Title of project:
NBCF application reference no. (INTERNAL USE ONLY): leave blank

Name of referee including title:
Referee job title:
Referee’s organisation/institution:
Address:
Post code:
Email address:
Contact tel:
Date:

1. Please comment on:

a) the quality of the applicant's academic record


b) the significance of the research proposal to contribute to breast cancer research


c) how the intended research institution will support the applicant to undertake the
   proposed research project.



Referee 1 Signature:

Date:

Note: We will accept electronic signatures.




                                              Page 2 of 4
                 Doctoral Research Scholarship – Referees in confidence

        Applicant assessment – detailed comments - completed by Referee 2 only

Definition of Referee 2:
Independent referee with knowledge in the proposed field of research
This referee is to have had no substantive professional or private contact with the applicant or to
have had any previous or current collaboration with the applicant’s recent or future supervisors, but
should be knowledgeable in the field of study. The referee should not be at the applicant’s current
institution.

The referee should forward their report in a sealed envelope to the applicant, so that the applicant
can submit the report with the application by the due date. Alternatively, email their report to
research@nbcf.org.au by the due date.

Please address all headings outlined below. Your comments can extend onto additional pages.

Name of applicant:
Title of project:
NBCF application reference no. (INTERNAL USE ONLY): leave blank

Name of referee including title:
Referee job title:
Referee’s organisation/institution:
Address:
Post code:
Email address:
Contact tel:
Date:

1. Please comment on:

a) the quality of the applicant’s academic record

b) the feasibility, originality and quality of the proposed project, including the significance
of the research proposal to contribute to beast cancer research

c) the environment of the host institution


Referee 2 Signature:

Date:

Note: We will accept electronic signatures.




                                              Page 3 of 4
                 Doctoral Research Scholarship – Referees in confidence

        Applicant assessment – detailed comments - completed by Referee 3 only

Definition of Referee 3:
Referee with personal knowledge of the applicant
The referee should forward their report in a sealed envelope to the applicant, so that the applicant
can submit the report with the application by the due date. Alternatively, email their report to
research@nbcf.org.au by the due date.

Name of applicant:
Title of project:
NBCF application reference no. (INTERNAL USE ONLY): leave blank

Name of referee including title:
Referee job title:
Referee’s organisation/institution:
Address:
Post code:
Email address:
Contact tel:
Date:

1. Please comment on the:

a) quality of the applicant’s academic record


b) the significance of the research proposal to contribute to breast cancer research


c) quality of the intended research institution, including supervision


2. Please comment specifically on the applicant’s professional research skills and future
research potential. Justify your comments with regard to the applicant’s current research
output.


3. What is the applicant’s capacity to take forward a vision, deliver the project, and to
develop as a future leader in breast cancer research in Australia?


Referee 3 Signature:

Date:

Note: We will accept electronic signatures.

                                              Page 4 of 4

								
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