2019 Falling Walls Lab Australia referee template

1. Applicant’s details

Name

Email address

Mobile number

2. Referee’s details

Name

Organisation

Department

Position

Organisation’s postal address

Country

Email address

Phone number (incl. area code)

3. How long have you known the applicant?

Years Months

4. Please describe the extent of your knowledge of the applicant.

5. How would you describe the applicant’s research and innovation aptitude when compared with others in the same category?

☐ Outstanding – the applicant is in the top 5%

☐ Excellent – the applicant is in the top 10%

☐ Very good – the applicant is in the top 20%

☐ Good – the applicant is in the top 30%

☐ Satisfactory – the applicant is in the top 50%

☐ Unsatisfactory – the applicant is NOT ready to present at FWL

6. Please comment on the applicant’s academic background.

7. Please comment on evidence of the applicant’s research and innovation potential (such as their research experience and training, including university studies, publications, papers and other relevant work).

8. Please provide any additional comments relevant to the applicant’s application to the Falling Walls Lab Australia.

Signature of referee:

Title and name:

Date: