The Durham MBA

Confidential Reference Form

This form should be used in connection with an application for the Durham MBA Programme. You should insert
your name below and send the form to your referees. The referee is requested to complete the form and return it
to you in a sealed envelope. If the referee prefers, he/she can complete the reference form and scan and email,
fax or post it directly to the relevant admissions office. Contact details are given at the end of the form.

Applicant’s Name

is applying to Durham University for admission to the MBA Programme. It would be of great assistance if you
would complete this form of reference. Any information that you provide will be considered strictly confidential.

Mode of Study: Distance Learning Full Time Executive (Part Time)

Caribbean Sinerghia Other …………………………….

Reference
A. How long have you known the applicant and in what connection?

B. How do you rate his/her academic ability? Do you think that (s)he is capable of study at
Master’s level?

C. To undertake an MBA requires a high degree of commitment and dedication over a significant
period of time. How do you rate the applicant’s ability in this respect?
D. What is your opinion of the applicant’s motivation to pursue management education? Taking an
overall view, what do you consider to be the applicant’s major talents and most significant weaknesses?

E. Please would you evaluate the candidate in terms of the qualities listed below:

Below Unable to
Outstanding Good Average
Average assess
Intellectual
ability
Capacity for
original
thought
Organisational
ability
Analytical
capacity
Emotional
maturity and
stability

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F. (For applicants whose first language is not English). Please comment on the applicant’s level of
English language proficiency and his/her capacity for oral and/or written expression (eg, use in the
working environment).

G. If you would care to add to any of your judgments, or if you wish to provide further information that
you consider might be relevant, please do so here.

H. How strongly do you support this application?

Recommend with
Strongly recommend
reservations
Recommend
Do not recommend

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Should the candidate request access, under the Data Protection Act 1998, to the personal data
held about them by Durham University, would you wish this reference to remain confidential?

Yes No

Signature Date

Name and Position Address

Telephone

Your assistance in providing this information is greatly appreciated.

Please return this form to the applicant in a sealed envelope.

If you prefer, you can scan and email, fax or post this form
directly to the Postgraduate Admissions Team.

Postgraduate Admissions Team

Durham Business School
Durham University
Mill Hill Lane
Durham
DH1 3LB
United Kingdom

Tel: +44 (0) 191 334 5533

Fax: +44 (0) 191 334 5136
Email: pg.bus@durham.ac.uk