ICE QUEST Undergraduate Scholarship

Confidential statement by referee

Guidance
The scholarship is awarded to students who have the potential to excel as civil
engineers and display all-round excellence. Please give the reasons why you believe the
applicant should be considered for a QUET scholarship.
Deadline and submission
The deadline for submission of this reference form is 5 June 20!. Please save this form as
the "#pplicant$s surname%Initial$ !e.g. mith"#$ and email it to %uest.reference&ice.org.u'
&e'eree in'ormation
(irst names!s$ Title
urname Position
)rganisation
*ddress line +
*ddress line ,
*ddress line -

Postcode Country
Telephone
Email

.ame of *pplicant

The information given in this reference is to the best of my 'nowledge complete and correct. !please tic'$
.ame /ate
Data (rotection #ct )D(#* ++,- 0CE maintains data on referees1 including addresses1 where notified. This will be used confidentially for
the purposes of administering QUET scholarship applications. 0CE may contact referees to notify them of the outcome of the application
and to provide information on QUET scholarships which may be of interest and benefit to you.
0f you do not wish to receive notification of the outcome of the application or information on QUET scholarships please tic' this box
Education 2 3earning Page + of + 4ersion + 5evision 6 7 ,8 9arch ,:+;
0CE-+<:a 5egistered Charity ,+:,=, 2 C:-8<,>