School of Psychology Confidential Academic/Professional Referees Report DOMESTIC APPLICANTS Applicant Please fill in these details Surname: Given

n Name(s): Address:

Phone (Day): Email: Program(s) you are applying for: MPsychol (Clinical) MPsychol (Forensic) MPsychol (Organisational) Referee Please fill in these details Referees Name: Position: Work Phone: Excellent Academic ability Verbal skills Writing skills Conscientiousness Interpersonal skills Maturity Response to supervision Ability to deal with stress 5 5 5 5 5 5 5 5

Phone (Evening): Fax:

Combined PhD/MPsychol (Clinical) Combined PhD/MPsychol (Forensic) Combined PhD/MPsychol (Organisational)

Email: Above Average 4 4 4 4 4 4 4 4 Average 3 3 3 3 3 3 3 3 Below Average 2 2 2 2 2 2 2 2 Poor 1 1 1 1 1 1 1 1

If English is not the applicant's first language please rate ability:

Excellent To speak English To write English To Understand English 5 5 5 Above Average 4 4 4 Average 3 3 3 Below Average 2 2 2 Poor 1 1 1

Academic suitability for this program Outstanding Above average Average Poor Not suitable at all

Personal suitability for this program Outstanding Above average Average Poor Not suitable at all

Overall level of support you would give to this candidates application Unqualified Very strong support Strong support Limited No support

Other comments: We would be interested to receive any additional comments from you regarding the

applicant's strengths and weaknesses. Please comment on strengths/weaknesses with respect to academic ability, communication/interpersonal skills, maturity, personal suitability for this program.

Strengths:

Weaknesses:

Referees signature: Date: Thank you for your time and cooperation. Please return this sheet to: School Manager School of Psychology The University of New South Wales UNSW Sydney NSW 2052 Australia