Part B – Statement by referee
To be completed by applicant
Applicant's full name
Course (see website for title: www.herts.ac.uk)
Date of Birth d d - m m - y y y y Male Female
Name and address to which reference is to be sent (ie your address)
Postcode Country
Email address
Notes for the guidance of referees
The referee's report is an integral and important part of the Mature applicants
selection process, and the information you give will help to Referees may have difficulty in commenting on the academic
guide admissions tutors in making their decisions. abilities of mature applicants who may not have any recent
educational experience, and in these circumstances, referees
In order that the University can evaluate an applicant's may wish to confine their comments to matters listed under
academic and intellectual capacity, your reference should if 1, 2c, 3, 4, 5 and 6 opposite.
possible cover:
Despatch arrangements
Having supplied the reference, please return it to the applicant.
1 Suitability for the course(s) applied for Seal the envelope, sign across the seal and cover your
signature with clear tape before returning it to the applicant
2 Intellectual qualities including:
(a) development to date and previous examination
performance with special reference
to any factors which may in your opinion have
adversely influenced the result;
(b) present performance;
(c) potential, including an assessment of the
probable results of any pending examinations.
3 Personal qualities
4 Career aspirations
5 Health and other personal circumstances relevant
to the application
6 Athletic, social and other interests
To be completed by the referee
This form may be photocopied: please type if possible, or write in black ink. Please affix official stamp, where appropriate, at the end
of the statement.
Name of referee
Post/Occupation/Relationship
How long have you known applicant
Name of School/College/Organisation
Address
Postcode Country
Telephone No Fax No
Email address
Name of applicant (block capitals or type)
Signed Date