Academic Reference Form

I have the capacity to evaluate the applicant as: (check all that apply)

If other please specify

How many years have you known the applicant?

Less than 1 year 1–2 years 3 years or more

I have known the applicant during the following periods of their academic career: (check all that apply)

If other please specify

Have you read the applicant’s research proposal?

Yes No

Are you the primary investigator (PI) for this student's project?

Yes No

Student Evaluation

Fill in the 3 fields below to fill in the blanks of this sentence:
OVERALL I would rank the applicant in the top (1)% of approximately (2) students at their current level that I have encountered in my (3) years of experience.

Academic excellence

Research Potential

Personal Characteristics

Please fill out this page ONLY IF you are the Principal Investigator of the project AND/OR the Primary Supervisor for the student. This page is intented to inform the broader lab context of the student's application. If you are NOT the student's PI, please skip this page the final submission page.

Please comment the learning environment and resources available to the student in your lab

Please comment on how this project fits into more broad lines of research in your lab:

This application is primarily the original written work of the student applicant

I agree

I understand that this is a matched funding opportunity and that I can supply 40% of the student's stipend.

I agree

Send me email updates on Branch Out Foundation activities, events, and news.

Yes, please.

I would be interested in assisting Branch Out's SRP to score applications in future years

Yes, please.

By checking this box, I acknowledge that I own the rights to all of the content submitted through this form.

Personal information

Student Evaluation

PI Questions

Consent

About

Get Involved

Research