Office of International Students and Scholars www.kwantlen.ca/exchange Internationalprograms@kwantlen.

ca

STUDENTS FOR DEVELOPMENT INTERNSHIP APPLICATION FOR SPRING 2012

REFERENCE FORM
The student for whom you are filling out this form is applying to participate in a Students for Development Internship funded by CIDA and AUCC in Cuba. We greatly appreciate your assistance in completing this process. For more information about the Students for Development Program, please visit: http://www.aucc.ca/programs/intprograms/sfd/sfd_e.php.

This form is to be returned to the student in an envelope that has been signed and sealed by you.
1. Student Information Last Name: 2. Faculty Information Instructor Name: Office Phone: Voicemail: Department: Email: First Name: Student #:

3. In what capacity have you known this student?

4. Has this student ever missed a deadline? Yes No 5. Please indicate your assessment of the students competence in the following areas in comparison with other students whom you have known at similar stages in their studies: Quality Self-motivated Articulate Perceptive Adaptable Responsible Self-reliant Intellectually Curious Interpersonal Skills Class Participation
Poor Below Average Average Above Average Outstanding n/a

Please See Over

Office of International Students and Scholars www.kwantlen.ca/exchange Internationalprograms@kwantlen.ca

STUDENTS FOR DEVELOPMENT INTERNSHIP APPLICATION FOR SPRING 2012

6.

I recommend this student In terms of character: Strongly Fairly With minor reservation I cannot recommend

In terms of academic ability: Strongly Fairly With minor reservation I cannot recommend

Please feel free to make additional comments in the space below or attach a separate page.

d d m m y y y y

Instructor Signature: FOR OFFICE USE ONLY Reference Score:

Date:

Scorers Initials: