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Breast Cancer Campaign referee report form - DOC

VIEWS: 5 PAGES: 4

									                     Early Career Fellowship – 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:
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 any active collaboration with the applicant’s proposed supervisors, but should be
knowledgeable in the field of study. The referee should not be at the applicant’s current institution.

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

1. Please comment specifically on the feasibility, originality and quality of the proposed
project.




2. Please comment on the potential of the project and the environment of the host
institution to enhance breast cancer research and the career development of the applicant




Referee 1 Signature:

Date:

Note: We will accept electronic signatures.




                                              Page 2 of 4
                     Early Career Fellowship – Referees in confidence

      Applicant assessment – detailed comments – completed by Referee 2 only

Definition of Referee 2:
Referee with personal knowledge of the applicant
Please address all headings outlined below. Your comments can extend onto additional pages.
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 telephone:
Date:

1. Please comment on the applicant’s promise to develop as a visionary leader in breast
cancer research. In particular please focus on his/her potential to:

a) Develop an outstanding team of talented and creative breast cancer researchers


b) Develop a mentoring role for his/her team to facilitate integration of these new
investigators into a successful research team.


c) Undertake research that is of major importance and with potential to impact on breast
cancer outcomes.


d) Enhance the quality of and foster the expansion of the scale and scope of breast cancer
research in Australia.


e) To build collaborative research partnerships beyond a single research environment or
research institution




                                            Page 3 of 4
2. Please comment specifically on the feasibility, originality and quality of the proposed
project.


3. Please comment on the proposed institution’s ability to assist and support the applicant.



Referee 2 Signature:

Date:

Note: We will accept electronic signatures.




                                              Page 4 of 4

								
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