East Central University

Student Information:

First Name:

Last Name:

Reference Information

The East Central University Department of Human Resources attach considerable weight to references' assessments of an applicant. Therefore, provide your candid assessment of the applicant’s preparation, motivation, and capacity for graduate study and potential for becoming successful in his/her chosen field. Thank you for your assistance.

Reference Name:

Position/Title:

Employer:

City/State:

Work Phone Number:

Preferred Contact Time:

In what capacity have you known the applicant?

How long have you known the applicant?

How well do you know the applicant?

In making decisions about the various areas listed below, compare the applicant with other persons you may have known with similar backgrounds and training. Mark  1 - Do Not Know if you feel you do not know enough about the applicant in a specific area.

1 = Do Not Know

2 = Disagree

3 = Agree, Low Confidence

4 = Agree, Moderate Confidence

5 = Agree, High Confidence

The applicant has demonstrated enthusiasm about training and working with persons with mental health issues. (Respond only if the applicant is applying to a counseling option.)

The applicant has demonstrated the abilities and discipline necessary to do graduate work.

There is a high correlation between what the applicant has said and what was done.

The applicant is a self-starter, willing to make decisions and take action.

The applicant takes full responsibility for his/her actions.

The applicant is a warm and caring person.

The applicant seeks out opportunities for new and diverse learning.

The applicant is flexible and open-minded (is responsive to others and revised thinking when "a better way" becomes evident).

The applicant quickly recovers from disappointment and failure.

The applicant is able to cope with uncertainty and ambiguity.

The applicant is responsive to feedback and supervision.

The applicant appears mature and makes good decisions.

If I were an employer and the applicant had the necessary academic background and training, I would:

Welcome the opportunity to employee him/her;

Be satisfied he/she would be accepted by and get along with other employees.

We appreciate your candor as well as your time in completing the reference form – Thank you.