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Referee Questionnaire

Bachelor of Social Work, Paetahi Tumu Kōrero - Bachelor of Counselling, Bachelor of Physiotherapy, and Bachelor of Midwifery.

Thank you for agreeing to act as a referee. The applicant is in the process of applying for entry at Wintec to study either a professional health or social practice programme.

As these programmes consist of personal development, professional development and academic study and work place experience, successful applicants need to have attributes which will ensure success in all the above. It is important, therefore, that we have information that will enable us to make sound selection choices.

This questionnaire has two functions:

  • To assess the suitability of the applicant for entry to a professional health or social practice programme,
  • To briefly identify the knowledge, skills and attributes the applicant will bring to the programme.

The information provided will be retained in a personal file held in the Wintec student management system. Please note that this report will be shared with the applicant if they request to see it.

Referee’s Details

Required *

Do you want the information you supply to be confidential to Wintec staff?
Do you know the applicant well enough to complete this form? If “yes” please select yes and continue. If “no” please select no and click submit at the end of this form. *

Applicant’s Details

Would you recommend this applicant to study and enrol in this Degree programme?
What programme is the applicant applying for?


I declare that to the best of my knowledge the answers I have provided are correct. I have not withheld any information that could have a material bearing on the applicant’s enrolment. *

Wintec will store your contact details to respond to your query, keep a profile of your interactions with Wintec, and send you promotional material.

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