Name of Applicant: _______________________________________________________

Name of Referee: ________________________________________________________

Occupation: _____________________      Telephone : ________________

Email _______________________________________

How long have you know the applicant? ___________________________________

In what capacity do you know the applicant? ___________________________________________________________________________

Please describe below the musical ability of the applicant, and why you think he is a worthy candidate for a bursary.

______________________________________		___________________
Referee's Signature		Date