Edith Cowan University
Student Services Centre - Scholarships
Academic Referee Report
General Frank Brown Scholarship
Section A
To be completed by Applicant
Please complete Section A and pass the form on to a person whom you wish to act as your academic
referee.
Please note you are required to provide 2 (two) Academic Referee Reports as part of your application.
At least one of these reports should be provided by a senior academic who is conversant with your
most recent studies.
Section A (to be completed by Applicant)
Title:
Mr Mrs Miss Ms
Surname/Family Name:
Contact Address:
Other
Given Name/s:
Country:
Email Address:
Telephone:
Any other identifying
information
Section B
To be completed by Academic Referee
This report is strictly confidential.
Please send the completed form direct to:
Senior Scholarships Officer
Edith Cowan University
270 Joondalup Drive
JOONDALUP
WESTERN AUSTRALIA 6027
OR Email: signed scanned copy to: scholarships@ecu.edu.au – not to the applicant
Reports received after the scholarships closing date
may not be considered.
Scholarship Closing Date: 31 December 2015
Section B (to be completed by Referee)
Title:
Mr Mrs Miss Ms
Surname/Family Name:
Position:
Name of Institution:
Institutions Address:
Telephone:
Professional Relationship to Applicant
(e.g. Course Coordinator, Lecturer)
Dr Prof. Other (please specify)
Given Name/s:
Email Address:
Scholarships Telephone: +61 8 6304 3636 Fax: +61 8 6304 2088 Email: scholarships@ecu.edu.au
Edith Cowan University
Student Services Centre - Scholarships
Section B
To be completed by Academic Referee
At what level of studies have you
Undergraduate Year
known the applicant?
1st yr 2nd yr 3rd yr
Other Please specify
4th yr
_______________________________________________________________
At what level would you rate the
applicant’s academic ability?
Based on the quality of completed
work, the applicant’s academic
Record is:
Based on the applicant’s overall
academic performance, the
applicant’s potential for
successfully undertaking Overseas
Study and the relevance of the
study,
Please indicate the degree of your
support for his/her application.
Top 5%
Top 6% to 20%
Top 21% to 40%
Top 41% or more
Outstanding
Very Good
Good
Mediocre
Poor
Unreserved
Strong
Fairly Strong
Moderate
Nil
General comments.
Please add any other comments that you feel are relevant to consideration of this application (for
example, motivation and initiative of the student).
Signature of
Referee:
Name:
(Please print)
Position:
Date:
Scholarships Telephone: +61 8 6304 3636 Fax: +61 8 6304 2088 Email: scholarships@ecu.edu.au