Durban University of Technology

Form CYC: BT2

Faculty of Health Sciences

DEPARTMENT OF COMMUNITY HEALTH STUDIES CHILD AND YOUTH CARE PROGRAMME

Application for Entry into the B.Tech: Child and Youth Development (Child and Youth Care) for 2018:

CONFIDENTIAL REPORT

Please note:

1. No application will be considered if no confidential report for the applicant is received.

2. This confidential report must be submitted DIRECTLY to the Child and Youth Care Programme, and NOT to the applicant.

Name of applicant: ______

For how long have you known the applicant? ______

In what capacity do you know her / him? ______

Write a brief report on the applicant’s abilities in terms of the following aspects:

1. Motivation to study: ______

______

1 2. Ability to integrate theory and practice: ______

______

3. Initiative and enthusiasm: ______

______

4. Ability to read, write, speak and understand English: ______

______

5. Interpersonal skills: ______

______

6. Academic ability: ______

______

2 ______

______

7. Leadership: ______

______

8. Personal and professional development of the applicant in the time that you have known her / him: ______

______

9. Professional integrity: ______

______

10. Particular strengths: ______

______

3 RECOMMENDATION (please tick appropriate box)

Would you recommend this applicant for the B.Tech: Child and Youth Development?

YES NO

Please provide reasons for your recommendation.

______

Referee’s full name: ______

Position: ______

Organisation address: ______

______

Contact details: ______

______

Signed: ______Dated: ______

Thank-you for completing this confidential report. Please submit by Friday 29 September 2017 directly to:

Jackie Winfield Department of Community Health Studies Child and Youth Care Programme Durban University of Technology P.O. Box 1334 DURBAN 4000

Fax: 086 674 0558 E-mail: [email protected]