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|This reference form is part of the UCL research scholarship application form. |

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|Applicant Full Name* |      |

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|[pic] |RESEARCH ACADEMIC REFERENCE FORM 1 *required fields |

|1. How long have you known the applicant?* | |2. In what capacity do you know the applicant?* |

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|3. The applicant is/was in top |      | % of students I have taught throughout my academic career.* |

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|4. The applicant is/was in top |      | % of students in the current year cohort.* |

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|5. Please comment on all following areas: the applicant’s academic performance, study/research skills, prizes and scholarships won, relevant personal |

|qualities, motivation and suitability for the intended programme or research project, as well as his/her career aims and prospects. Where applicable, explain |

|the grading structure of the qualifications attained and provide information about the distribution of grades within the cohort of students with which you are|

|comparing this student.* |

|(Please comment below or include a separate signed letter on headed paper. If a separate letter is provided we still require the other sections on this form |

|to be completed) |

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|6. Please comment on the applicant’s research potential.* |

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|7. |Recommendations* | | | |

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| |I strongly recommend this applicant for the above scholarship | | |I recommend this applicant for the above scholarship |

| |I do not recommend this applicant for the above scholarship | | |I am unable to comment |

|CONTACT DETAILS* |

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|First name |

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|Last name |

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|Name of Institution |

|Position |

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|Email |

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|Under the terms of the Data Protection Act 2018, an applicant has the right to access any reference submitted to UCL. Please tick this box if you do not wish |

|the applicant to have access to this reference. |

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|Signature |

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|Date |

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|Thank you for your co-operation in completing this form. Please submit this form electronically by sending it directly to the UCL Department where the |

|applicant is registered or to which the applicant has been admitted. A full list of administrative contacts can be obtained at |

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