Reference Form
A –Applicant Name......
Program: Materials Science and Engineering
Level: Master’s degree Doctoral degree
B–Referee name: ......
Institution: ...... Department: ......
Address: ......
City: ...... State: ...... Country: ......
Phone number: ......
E-mail: ......
______
C–Confidential information about the applicant:
1- I know the applicant since...... as my student in:
An undergraduate course A graduate Course Other(Specify)
2- With respect to the applicant, I was his/her:
Professor in a course Professor in several courses
Supervisor Head of department
Otherposition (specify)......
3–We would like to have your opinion about the applicant, who wishes to enroll in our Graduate Program. This confidential information is needed to be able to judge his/her suitability, capacity and initiative for advanced studies and research. In comparison with other students with whom you have worked in the last five years, please rate the applicant in terms of the following categories:
Excellent(upper 5%) / Good
(upper 20%) / Average
(upper 50%) / Below average / Not
Observed
Intellectual Capacity
Motivation for advanced studies
Ability for individual work
Ability to communicate in writing
Ability to communicate orally
Overall evaluation
......
4- Does the academic record properly reflect his/her ability?
Yes No (if not, please justify)
......
5–Please write your opinion about the applicant's suitability and ability to pursue advanced studies and research, justifying your answer:
......
6–I would recommend the acceptance of the applicant in my own graduate program:
Without reservationDefinitely not
With some reservation(specify) We don´t offer similar program
......
______, ____/____/______
Place and dateSignature
Please, send this form directlyto: / E-mail: ppgmat.ufsc.brA/C Sr. Rogério Antônio Campos
PGMAT - UFSC/CTC/EMC - Bloco “A” da EMC - Campus Universitário - Trindade - Caixa Postal 476 - CEP: 88040-900 - Florianópolis-SC
FONE: (048) 331.9415 - FAX: (048) 234.1519 – E-MAIL: .