Study Abroad/International Office Student Reference
Application Instructions
This form should be completed by the student’s current Study Abroad/International Office at
their University/College. Please return the form (digital copy preferred) to the student, who
will upload it with their application to Goldsmiths.
NB: If the student is not currently attending a University/College, then this form can be
completed by a High School Counselor or similar.
Student information
Student’s first name:
Student’s last name:
Student’s home institution:
Confirmation of student’s suitability
1. Is the applicant a full-time student in good standing at your institution?
Yes
No (please explain)
I do not have access to this information
2. Has the applicant ever been on academic probation
Yes (please explain)
No
I do not have access to this information
3. Has the student ever been involved in any disciplinary action whilst attending your institution?
Yes (please explain)
No
I do not have access to this information
Declaration
I am recommending this student to participate in the Goldsmiths Study Abroad programme.
First name:
Last Name:
Signature:
Date: