International Doctoral Fellowship Reference Form

2018-2019 Competition

To the APPLICANT: Complete the shaded area below before sending this form to your referee. Completed reference forms must be sent directly to the Graduate Program to which you are applying / transferring.

Last name of applicant / First name of applicant
UBC Graduate Program the applicant is applying for admission / transferring to
Mailing Address:
Phone: / Email:

To the REFEREE: Please complete the sections below. Please sign your reference form before submitting it to the UBC Graduate Program above. A letter of reference may be submitted in lieu of this form (maximum 2 pages). A scanned copy of a signed reference form or signed letter may be submitted by email to the graduate program.

In what capacity, how well, and for how long have you known the applicant?
Does your university offer the graduate degree this applicant seeks?
Yes No
If yes, does the applicant meet the minimum admission requirements for acceptance to this program at your university?
Yes
No (give reasons below)
If the applicant took a course(s) from you, what was his/her rank in the class?
Course Name: / Course Number: / Rank in Class:
Course Name: / Course Number: / Rank in Class:
Please rank the applicant as follows: 0 = Poor, 1 = Fair, 2 = Good, 3 = Very Good, 4 = Excellent, 5 = Outstanding
Rank / Remarks
Academic Preparation
Originality
Skill at Research
Industriousness
Intellectual Capacity
Teaching Ability (if known)
All-round Ability
Please comment on the applicant’s strengths and potential for completing a graduate program.
Please indicate whether the applicant has sufficient competence in English to:
a. understand lectures conducted in English
b. read widely in English
c. express herself/himself in written English
Referee’s Contact Information (required)
Institution:
Mailing Address:
Phone:
Email:
Referee’s Name (printed):
Referee’s Title:
Referee’s Signature: / Date (yyyy/mm/dd):

This confidential Report must be both prepared and signed by the referee named above. Evidence to the contrary will lead to the cancellation of any offer of funding (whether accepted or not). The information provided on this form is collected pursuant to section 26 of the Freedom of Information and Protection of Privacy Act ( It will be used only for adjudication purposes in accordance with section 32 of the Act. The Act permits reviewer comments to be disclosed to the candidates, subject to the exceptions in the Act. Generally, your identity as a referee will be protected. However, due to the nature of the application process, applicants are usually aware of who has completed their evaluation. As a result, you cannot expect privacy or anonymity.

International Doctoral Fellowship Reference Form 2018-2019 / page 1 of 2 / last updated: 2017-11-09