Bursary Referee's Report Form

	Use back button to return to previous page

Thank you for offering to provide a reference for an applicant to the Bursary Scheme of the Biritish Division of the International Academy of Pathology.
Use of this form is not mandatory, but may help you to provide the necessary information. Please print out this page, fill in the form legibly, preferably with a typewriter, and post it to:

Dr Stephen Wells, Department of Histopathology, Royal Bolton Hospital, Minerva Road, Farnworth, Bolton, BL4 0JR, U.K.
Or fax the form to: (+44)1204 390946

BDIAP Bursary: Referee's Report

in support of Dr .............................................. (Please enter name)

Your name:

Your address (For correspondence):

How long have you known the applicant?................................................................

Please describe briefly your involvement in his / her training.

.....................................................................................................................................................

Please indicate how the requested period of training will benefit your institution

.....................................................................................................................................................

Please give a summary of your assessment of the candidate, with particular reference to the candidate's ability to benefit from the requested period of training within the area of the British Division. Contunue on another page if necessary.

.....................................................................................................................................................

We regret that it may not be possible to acknowledge receipt of applications. Successful applicants will be informed by post.