This form is currently not available for submission.  Applications have closed.

The referee report needs to be completed and returned by 07 October 2011. An extension for the submission of this form has been granted until midnight Monday 17 October, 2011.

To avoid delay with the applicant's assessment, it is recommended that this form is submitted as soon as possible.

The information you provide on this form is confidential in accordance with Section 35 of the Freedom of Information Act 1982 (Victoria).

An applicant of Australian Catholic University (ACU) has applied for a place in one or more postgraduate psychology courses and has named you as an academic referee in support of their application.

Name of ACU Applicant

Referee Name

Referee Position/Title

Referee Phone Number

Referee Fax Number

Referee Email

Relationship to Applicant

University where applicants studies were undertaken

Applicants final exam results

•  Predicted
•  Actual

The applicant is:

Not known by the refereeH1H2A UpperH2A LowerOther – Please specify: 

If other, please specify:

Academic Ability

Outstanding  (Top 5%)Superior (Top 6 – 10%)Very Good (Top 11 – 25%)Good (Top 26 – 40 %)Average (Top 41 to 60%)Below Average (Bottom 40%)Don’t know 

Research Ability

Outstanding  (Top 5%)Superior (Top 6 – 10%)Very Good (Top 11 – 25%)Good (Top 26 – 40 %)Average (Top 41 to 60%)Below Average (Bottom 40%)Don’t know 

Writing Skills

Outstanding  (Top 5%)Superior (Top 6 – 10%)Very Good (Top 11 – 25%)Good (Top 26 – 40 %)Average (Top 41 to 60%)Below Average (Bottom 40%)Don’t know 

Oral Skills

Outstanding  (Top 5%)Superior (Top 6 – 10%)Very Good (Top 11 – 25%)Good (Top 26 – 40 %)Average (Top 41 to 60%)Below Average (Bottom 40%)Don’t know 

Organisational Skills

Outstanding  (Top 5%)Superior (Top 6 – 10%)Very Good (Top 11 – 25%)Good (Top 26 – 40 %)Average (Top 41 to 60%)Below Average (Bottom 40%)Don’t know 

Interpersonal Skills

Outstanding  (Top 5%)Superior (Top 6 – 10%)Very Good (Top 11 – 25%)Good (Top 26 – 40 %)Average (Top 41 to 60%)Below Average (Bottom 40%)Don’t know 

Perseverance

Outstanding  (Top 5%)Superior (Top 6 – 10%)Very Good (Top 11 – 25%)Good (Top 26 – 40 %)Average (Top 41 to 60%)Below Average (Bottom 40%)Don’t know 

Flexibility/Adaptiveness

Outstanding  (Top 5%)Superior (Top 6 – 10%)Very Good (Top 11 – 25%)Good (Top 26 – 40 %)Average (Top 41 to 60%)Below Average (Bottom 40%)Don’t know 

Your level of knowledge of the applicant

•  High
•  Medium
•  Low

Based on your knowledge of the applicant, please indicate the level of your support for their application:

•  Unreserved
•  Strong
•  Moderate
•  Reserved
•  Nil

Additional comments