APPLICATION FOR STUDY IN THE UNITED STATES

CONFIDENTIAL LETTER OF REFERENCE

This letter of reference must be accomplished by a teacher under whom the applicant has studied or pursued research in the proposed field of study or by someone who has supervised the applicant in work related to the proposed field of study. This letter should be in English and typewritten or printed from a computer. INSTRUCTION TO THE REFEREE: Please accomplish this form and put in an envelope. To ensure confidentiality, affix your signature across the seal of the envelope.

NAME OF APPLICANT :

NAME OF REFEREE: I. II.

HOW LONG HAVE YOU KNOWN THE APPLICANT?

IN WHAT CAPACITY HAVE YOU KNOWN THE APPLICANT? TEACHER OR PROFESSOR RESEARCH ADVISER EMPLOYER OR JOB SUPERVISOR OTHER (pls. specify)

III.

PLEASE PROVIDE A CANDID EVALUATION OF THE APPLICANTS PAST PERFORMANCE AND ABILITY TO PURSUE AND SUCCESSFULLY COMPLETE A PROGRAM OF STUDY IN THE PROPOSED FIELD. Your statement will be given considerable importance by the Selection ommittee reviewing this student!s application, and should, therefore, be as complete and detailed as possible. Your comments should be continued on the reverse side if more space is needed.

T"# $#%#$S# S&'# () T"&S )($* S"(+,' -,S( .#

(*P,#T#'.

CONFIDENTIAL LETTER OF REFERENCE (Con !n"#$%

III. (Con !n"#$ &'o( '#)#'*# *!$# !& (o'# *+,-# !* '#."!'#$%

IV.

IN THE RATING CHART BELOW/ PLEASE EVALUATE THE APPLICANT IN COMPARISON WITH OTHER STUDENTS WHOM YOU HAVE KNOWN DURING YOUR PROFESSIONAL CAREER.
E0CELLENT VERY GOOD AVERAGE BELOW AVERAGE

&ntellectual -bility /nowledge of )ield 0ork "abits *otivation to Pursue 1raduate Study Seriousness of Purpose Potential for Significant )uture ontribution to )ield $esourcefulness and &nitiative #motional *aturity -daptability to 2ew Situations ,eadership 3ualities Teaching Potential

V.

PLEASE INDICATE WHERE THE APPLICANT WOULD RANK AMONG STUDENTS CURRENTLY OR RECENTLY IN YOUR DEPARTMENT.

123

143 T(P

523

243

623 .(TT(*

N,(# ,n$ T! 7# (in print) In* ! " !on,7 A&&!7!, !on S!8n, "'#

D, # P7#,*# '# "'n $!'#- 79 o T:# FULBRIGHT SCHOLARSHIP COMPETITION P:!7!++!n#;A(#'!-,n E$"-, !on,7 Fo"n$, !on <4=F A9,7, L!&# > FGU C#n #' ?@<< A9,7, A)#n"#/ M,A, ! C! 9 <66? NOTE: P-#) cannot guarantee this letter!s confidentiality once it becomes part of P-#)!s records.