School of Graduate Studies
Academic Letter of Appraisal
Applicants: Send a link of the letter of appraisal form to your referee by email, and include your full name, date of birth, and Memorial student number (if known).
Referees: Version 8 or higher of Adobe Reader is required to complete this form. Download the latest version at http://get.adobe.com/reader/ (Mac users editing with
Preview: Save the form by clicking File -> Print. Click the PDF button in the lower left corner, then click 'Save as PDF'). Complete this entire form, and submit. Do not type
beyond allotted space. This form is confidential when complete. If you are using an Internet email service such as Yahoo or Hotmail, please save completed form and return
manually to firstname.lastname@example.org.
SECTION 1: APPLICANT INFORMATION
Last name Middle name First name
MUN# (if known) Date of birth (DD/MM/YYYY) Academic unit
SECTION 2: REFEREE INFORMATION
Mailing address Name
Title or rank
(e.g. , Associate Professor)
Institutional email address
(e.g. , email@example.com)
(e.g. , (709) 555-5555)
SECTION 3: REFEREE REPORT
How long have you known the applicant, and in what capacity? What university courses have you taught the applicant?
Please rank the applicant using the scale below using students from the last five years as a comparison group.
Top 5% Top 10% Top 25% Top 50% Bottom 50% Inability to observe
Originality and initiative
Industry and perseverance
Ability to work independently
Ability to communicate in English (oral)
Ability to communicate in English (written)
This applicant is (Please select from drop-down list) for admission to graduate school.
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School of Graduate Studies
SECTION 4: LETTER OF REFERENCE
Please use the space below to comment on the applicant's strengths and overall potential for completing a graduate degree at Memorial.
SECTION 5: DECLARATION, SIGNATURE, AND SUBMISSION OF FORM
I certify that the information contained in this form is complete and correct to the best of my knowledge. I understand that the School of Graduate Studies will verify
documents submitted in support of a graduate application, and that submission of falsified documents is considered a serious offence.
I have read and agree with the above declaration.
Type full name Submit by Email
Date (DD/MM/YYYY) Print Form
Please print a copy of this form for your records.
Memorial University protects your privacy and maintains the confidentiality of your personal information. The information requested in this form is collected under the general
authority of the Memorial University Act (RSNL1990CHAPTERM-7). It is required for the processing of your application and for administrative purposes of the School of Graduate
Studies. If you have any questions about the collection and use of this information, please contact the Graduate Enrolment Manager at 737-2445 or at firstname.lastname@example.org
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