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Fill in your name, and give a copy of this form to each reference person. Name of applicant: first name middle name surname To reference person: Please complete this form, seal it in an envelope, sign across the seal and return it to the applicant for enclosure with the application form. If you do not know the applicant well enough to complete this form, please feel free to say so. Name of person completing this form: Position/Title: Organization: Mailing address: Phone: ____________________________________________ Fax: ________________________________________ E-mail: How long have you known the applicant? ________ years and ________ months The applicant was then ( undergraduate student ( master抯 student ( research assistant ( teaching assistant ( employee ( You served as the applicant抯 ( division/dept./school head ( research supervisor ( teacher in several classes ( employer ( teacher in only one class ( immediate supervisor ( dailyweeklymonthlyrarelyneverHow often have you observed him/her?At workAt schoolSocially -to be continued If you observed the applicant in the role of teacher, how would you rate his/her academic record in comparison with other students in the class? ( Truly exceptional ?Top 2% ( Outstanding ?Top 5% ( Excellent ?Top 10% ( Good ?Top 20% ( Average ?Upper 50% ( Below average ?Lower 50%, but recommended. ( Not recommended. In comparison with other students of your acquaintance in the same field, how would you rate the applicant抯 overall academic ability? ( Truly exceptional ?Top 2% ( Outstanding ?Top 5% ( Excellent ?Top 10% ( Good ?Top 20% ( Average ?Upper 50% ( Below average ?Lower 50%, but recommended. ( Not recommended. Some gifted individuals may have mediocre academic records. In your opinion, is the applicant抯 academic record an accurate index of his/her academic ability? ( Yes ( No ( Don抰 know If your answer is 揘o? please explain briefly. Poor Average Good Outstanding Describe the applicant抯 competence in his/her area of study. ( ( ( ( Evaluate the applicant抯 skill in maintaining personal ( ( ( ( relationships with others. Describe the applicant抯 English comprehension ability. ( ( ( ( You, therefore ( strongly recommend ( recommend ( recommend with some reservation ( do not recommend that this applicant be admitted to the Graduate School of Engineering, Kochi University of Technology. -to be continued Please comment freely about the applicant in the following space. Signature: _______________ ___ _______ Date: _______________________     Page  PAGE 2  )@AZ[mo??? & 6 7 p r s ?????燔椅藕椽∥艠艠惻嚺~s猟ZKZh^u?CJOJQJnHo(tHh^u?CJOJQJh^u?CJOJQJnHo(tHh^u?6丆JOJQJhnu?nHo(tHh<8?nHo(tHh?qnHtHh?qnHo(tHh^u?5丆J\?h^u?CJOJQJ h^u?CJh^u?CJnHo(tHh^u?nHo(tHh^u?h^u?CJOJQJh^u?B*CJ OJQJo(ph?&h,].B*CJ OJQJnHo(ph?tH ?@AZ[p q r s ?F G H M N u ???????????????????????? ??? ???dP? ?3f? d ???d ???d$$d轧a$??????  F G H \ ??M ???   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