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 ACU applicant has applied for a place in one or more postgraduate psychology courses and has named you as a professional/personal referee in support of their application.

Name of Applicant

Name of Referee

Position/Title

Phone Number

Fax Number

Email

Relationship to Applicant

Please complete the following ratings based on your perceptions of the applicant. If possible, compare the applicant to persons of a similar age.

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  MediumLow   

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

UnreservedStrongModerateReservedNil 

Additional Comments

Declaration

•  I declare that the information provided by me is true and complete at the time of submission.

Once you hit the submit button, your referee report will be sent to Admissions at ACU. Thank you for time and cooperation.