UNDERGRADUATE FUNDING AWARDS ACADEMIC REFERENCE FORM
IMPORTANT: ONLY COMPLETE THIS FORM IF THE APPLICANT IS APPLYING FOR PINDELSKI-BARRACK
BURSARY OR GREEK BURSARY
Only complete this form if you have detailed knowledge of the applicant
Scholarship
Name
Applicant Full Name
1. How long have you known the applicant?
- select -
2. In what capacity do you know the applicant?
3. The applicant was in top
% of students I have taught throughout my academic career.
4. The applicant was in top
% of students in the current year cohort.
5. Only
% of students in that year cohort can expect to achieve approximately the same grades as the applicant.
CONTACT DETAILS
Title
First name
Name of Institution
Position
Tel
Email
Last name
Address
Line 1
Line 2
Line 3
City
Country
Postcode
Comment on the applicant’s academic performance and achievements, Prizes and Scholarships won, relevant study skills, relevant
personal qualities, motivation, and suitability for the intended programme of study, as well as their career aims and prospects.
Provide other factual, concrete and comparative information about the applicant's performance. Include any distinctive
achievements which differentiate the applicant from others. This text box will expand and references should be 250-500 words
long.
Under the terms of the Data Protection Act (1998), an applicant has the right to access any reference submitted to UCL. However there are some
limited grounds for refusing aspects of a reference if they have been provided in confidence. Were this to be the case we would consult you, the
referee, to ascertain your thoughts on disclosure and ask for concrete reasons as to why disclosure would be a problem. We would then have to
balance the subject’s right to know information that has been written about them with any duty of confidence we owe you, the referee.
(Type Name if emailing)
Date
Signature
References should be saved as “<Candidate’s surname, candidates first name> UGFA Reference”
and emailed directly by the referees to Student Funding Office studentfunding@ucl.ac.uk
The email subject must be marked: “UGFA Reference for <candidate name>”.
Emails must be sent from the Referees work email address – they cannot be accepted if sent from a personal email address.