Beasiswa Kedokteran S2 di Eropa (Beasiswa Penuh) Deadline 14 Januari 2018 – IDBeasiswa
IMIM Reference Form
www.innovativemedicine.eu
Please return via email to imimreferences@rug.nl before 14 JANUARY 2018 (23:59 CET)
General information
The Erasmus+ International Master in Innovative Medicine (IMIM) is an English-taught , 2-year selective master,
fo usi g o the edu atio of to o ow’s leadi g t a slatio al io edi al esea he s; www.innovativemedicine.eu.
You have been approached by one of the applicants to this programme; we would appreciate your personal evaluation
of the applicant's scientific aptitude, intellectual ability and personal characteristics which would influence their
potential success in an ambitious and international programme like IMIM.
Please make sure the form is first downloaded, saved (with the last name of the candidate in the file name) and then
opened in Adobe before filling it out; filling it out in your web browser often causes filled out details to remain
unsaved.
Please fill in the a didate’s a e a d all othe i fo atio e uested i the fo
elow. You a add a y additio al
relevant information on the last page of this document (or attach a separate reference letter). After having filled in all
requested information, please save the filled out form and send it to imimreferences@rug.nl with the students name in
the email subject bar.
Candidate information
Full name of candidate (first, last)
Details referee
Family/last name
First name
Position/title
Name institution
Department
Country
Contact e-mail
General questions
How long have you known the applicant?
How do you know the applicant (e.g. thesis supervisor, lecturer)?
Would the applicant be eligible for admission to a scientific master programme at your institution (applicable
if you work at an institute of higher education)?
With the support of the Erasmus+ programme of the European Union. This project has been funded with support from the European Commission. This
publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information
contained therein.
IMIM Reference Form
www.innovativemedicine.eu
Would you consider the applicant qualified to participate in a selective research oriented programme like
IMIM? If so, why?
Have you identified any academic deficiencies which the applicant may have to remedy during his/her further
studies?
Competences
Please rate the candidate on the following comptences/characteristics by checking the appropriate box.
Truly
Excellent
Good
Average
Below
Insufficient
outstanding
average
information
Aptitude for pursuing an MSc
☐.
☐.
☐.
☐.
☐.
☐.
Depth and breadth of
☐.
☐.
☐.
☐.
☐.
☐.
academic knowledge
Research skills
☐.
☐.
☐.
☐.
☐.
☐.
Ability to take initiative
☐.
☐.
☐.
☐.
☐.
☐.
Communication skills
☐.
☐.
☐.
☐.
☐.
☐.
Stamina in completing tasks
☐.
☐.
☐.
☐.
☐.
☐.
Ability to work independently
☐.
☐.
☐.
☐.
☐.
☐.
Ability to work with others
☐.
☐.
☐.
☐.
☐.
☐.
Ability to handle criticism
☐.
☐.
☐.
☐.
☐.
☐.
Other relevant competences
(please specify):
☐.
☐.
☐.
☐.
☐.
☐.
☐.
☐.
☐.
☐.
☐.
☐.
☐.
☐.
☐.
☐.
☐.
☐.
☐.
☐.
Please rank the applicant relative to other students in the same cohort, or at the same stage in their career (please tick the
appropriate box).
☐Top 1-2%
☐Top 5%
☐Top 10%
☐Top 1-2%
☐Top 25%
☐Other
Additional statement
Please use this space to provide a written reference. Alternatively, we also accept a separate statement or
letter of reference attached to this filled out form.
With the support of the Erasmus+ programme of the European Union. This project has been funded with support from the European Commission. This
publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information
contained therein.
IMIM Reference Form
www.innovativemedicine.eu
Confirmation
In lieu of a handwritten signature, please check the box below:
I hereby declare that I have performed, to the best of my knowledge and abilities, an accurate and confidential assessment
of the applicant as mentioned on this reference form.
☐ Confirming the above
Name
Date
With the support of the Erasmus+ programme of the European Union. This project has been funded with support from the European Commission. This
publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information
contained therein.
www.innovativemedicine.eu
Please return via email to imimreferences@rug.nl before 14 JANUARY 2018 (23:59 CET)
General information
The Erasmus+ International Master in Innovative Medicine (IMIM) is an English-taught , 2-year selective master,
fo usi g o the edu atio of to o ow’s leadi g t a slatio al io edi al esea he s; www.innovativemedicine.eu.
You have been approached by one of the applicants to this programme; we would appreciate your personal evaluation
of the applicant's scientific aptitude, intellectual ability and personal characteristics which would influence their
potential success in an ambitious and international programme like IMIM.
Please make sure the form is first downloaded, saved (with the last name of the candidate in the file name) and then
opened in Adobe before filling it out; filling it out in your web browser often causes filled out details to remain
unsaved.
Please fill in the a didate’s a e a d all othe i fo atio e uested i the fo
elow. You a add a y additio al
relevant information on the last page of this document (or attach a separate reference letter). After having filled in all
requested information, please save the filled out form and send it to imimreferences@rug.nl with the students name in
the email subject bar.
Candidate information
Full name of candidate (first, last)
Details referee
Family/last name
First name
Position/title
Name institution
Department
Country
Contact e-mail
General questions
How long have you known the applicant?
How do you know the applicant (e.g. thesis supervisor, lecturer)?
Would the applicant be eligible for admission to a scientific master programme at your institution (applicable
if you work at an institute of higher education)?
With the support of the Erasmus+ programme of the European Union. This project has been funded with support from the European Commission. This
publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information
contained therein.
IMIM Reference Form
www.innovativemedicine.eu
Would you consider the applicant qualified to participate in a selective research oriented programme like
IMIM? If so, why?
Have you identified any academic deficiencies which the applicant may have to remedy during his/her further
studies?
Competences
Please rate the candidate on the following comptences/characteristics by checking the appropriate box.
Truly
Excellent
Good
Average
Below
Insufficient
outstanding
average
information
Aptitude for pursuing an MSc
☐.
☐.
☐.
☐.
☐.
☐.
Depth and breadth of
☐.
☐.
☐.
☐.
☐.
☐.
academic knowledge
Research skills
☐.
☐.
☐.
☐.
☐.
☐.
Ability to take initiative
☐.
☐.
☐.
☐.
☐.
☐.
Communication skills
☐.
☐.
☐.
☐.
☐.
☐.
Stamina in completing tasks
☐.
☐.
☐.
☐.
☐.
☐.
Ability to work independently
☐.
☐.
☐.
☐.
☐.
☐.
Ability to work with others
☐.
☐.
☐.
☐.
☐.
☐.
Ability to handle criticism
☐.
☐.
☐.
☐.
☐.
☐.
Other relevant competences
(please specify):
☐.
☐.
☐.
☐.
☐.
☐.
☐.
☐.
☐.
☐.
☐.
☐.
☐.
☐.
☐.
☐.
☐.
☐.
☐.
☐.
Please rank the applicant relative to other students in the same cohort, or at the same stage in their career (please tick the
appropriate box).
☐Top 1-2%
☐Top 5%
☐Top 10%
☐Top 1-2%
☐Top 25%
☐Other
Additional statement
Please use this space to provide a written reference. Alternatively, we also accept a separate statement or
letter of reference attached to this filled out form.
With the support of the Erasmus+ programme of the European Union. This project has been funded with support from the European Commission. This
publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information
contained therein.
IMIM Reference Form
www.innovativemedicine.eu
Confirmation
In lieu of a handwritten signature, please check the box below:
I hereby declare that I have performed, to the best of my knowledge and abilities, an accurate and confidential assessment
of the applicant as mentioned on this reference form.
☐ Confirming the above
Name
Date
With the support of the Erasmus+ programme of the European Union. This project has been funded with support from the European Commission. This
publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information
contained therein.