Academic Recommendation / Reference Form

Academic Recommendation / Reference Form

Thank you for taking the time to provide a recommendation in support of this applicant. Your feedback is an important part of the admissions review process. All responses will remain confidential and will be reviewed only by the Admissions Committee.
Applicant Information
Applicant Name*

First NameLast Name
Program Applied To
Recommender Information
Name of the Recommender *

First NameLast Name
Professional Title / Position*
Organization / Institution*
Email Address of the Reference*
example@example.com
Phone Number of the Reference*
Please enter a valid phone number.Format: (000) 000-0000.
Relationship to Applicant
How do you know the applicant?*
Length of time you have known the applicant:*
Evaluation of the Applicant

Using your experience with the applicant, please rate them in the following areas:
Academic Ability*

Not Observed / Poor / Fair / Good / Very Good / Excellent
Professional Competence*

Not Observed / Poor / Fair / Good / Very Good / Excellent
Work Ethic and Reliability*

Not Observed / Poor / Fair / Good / Very Good / Excellent
Communication Skills*

Not Observed / Poor / Fair / Good / Very Good / Excellent
Leadership Potential*

Not Observed / Poor / Fair / Good / Very Good / Excellent
Please describe the applicant’s strengths and qualifications for graduate-level study.*
In what areas could the applicant continue to grow or improve?
Please provide any additional comments you believe would be helpful to the Admissions Committee.
Overall Recommendation for Admission*
Consent:

I, the undersigned, hereby request a reference from the named individual for the specified purpose. I understand that the reference provided will be confidential and used solely for the intended purpose.
Date

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Signature
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Academic Recommendation / Reference Form

Applicant Information

Recommender Information

Relationship to Applicant

Evaluation of the Applicant