New Zealand College of Midwives: Rural Midwifery Student Grant: Midwifery school referee form

Please send the completed Application Form to New Zealand College of Midwives National Office: PO Box 21-106, Christchurch 8143 or via email nzcom@nzcom.org.nz with

Rural Midwifery Student Grant in the subject line by Monday 26th February 2018

Application Form for Midwifery School Referee - to be completed by a lecturer from the undergraduate programme that the student is enrolled in

Name: of person completing the form

Role: of person completing the form

Name of Midwifery School:

Name of midwifery student seeking reference to accompany grant application:

Please comment on the academic and clinical skill development of the applicant Please comment on the personal qualities of the applicant Please comment on your views on the suitability of the applicant for rural practice upon graduation

I confirm that the applicant has met the requirements to enable enrolment in the 3rd year of the undergraduate midwifery programme in 2018.