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Reference

Nouveau formulaire de répondant New reference form

In place of this report, you may also use an equivalent evaluation form issued by a Canadian institution such as NSERC, CIHR, SSHRC, FRSQ, FQRNT, or FQRSC. Please email it to registrariat@inrs.ca or mail to the following address :

Registrar's Office

490, rue de la Couronne

Québec, (Québec) G1K 9A9

Student

Last name		First name

Reference

Last name		First name
Institution		Position
Email		Telephone (office)
Address		Postal code
Country		Province/state

Knowledge of applicant

How well do you know the applicant?		Length of collaboration	to
In what capacity?		If other, please specify

Assessment of applicant

Using the scale provided, please rate the applicant in each of the following areas in comparison to others at the same stage in their education and give the reasons for your assessment.

1. Knowledge acquired	A - Exceptional, top 10% B - Above average, next 20% C - Average, next 20% D - Below average, next 50% N - Do not know applicant well enough	Reasons
2. Judgment and maturity	A - Exceptional, top 10% B - Above average, next 20% C - Average, next 20% D - Below average, next 50% N - Do not know applicant well enough	Reasons
3. Originality and imagination	A - Exceptional, top 10% B - Above average, next 20% C - Average, next 20% D - Below average, next 50% N - Do not know applicant well enough	Reasons
4. Clarity of oral and written expression	A - Exceptional, top 10% B - Above average, next 20% C - Average, next 20% D - Below average, next 50% N - Do not know applicant well enough	Reasons
5. General aptitude for research and/or professional work	A - Exceptional, top 10% B - Above average, next 20% C - Average, next 20% D - Below average, next 50% N - Do not know applicant well enough	Reasons
6. Overall assessment and other comments	A - Exceptional, top 10% B - Above average, next 20% C - Average, next 20% D - Below average, next 50% N - Do not know applicant well enough	Reasons

Conclusion

	I certify that the information contained herein is accurate.

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