MSW Letter of Recommendation Form by iuq51574

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									                          MSW Letter of Recommendation Form
Part I: To the Applicant
If you are willing for this to be a confidential evaluation, please sign the Waiver of Access.
Waiver of Access:            I waive the right of personal access to this reference.

                           Signed ______________________________ Date _____________________
Fill in your name and social security number below. Give this form to your evaluator along with a stamped
envelope addressed to: The Graduate School, 209 Tillman Hall, Winthrop University, Rock Hill, SC
29733.

Applicant’s Name ____________________________                             Soc. Sec. No. ________________

Part II: To the Person Evaluating the Applicant
If the applicant has signed the Waiver of Access (above), this evaluation will be confidential. If the Waiver
is unsigned, the evaluation is open to the applicant. Please evaluate this applicant using the following key
to indicate your judgment, and mail this form back to The Graduate School office.

Rating Key: In comparison with others with the same amount of education and experience, this applicant
is: (Please omit any item for which you have no basis for judgment)

1. Outstanding (top 5%)    2. Above Average            3. Average         4. Below Average


                                                                         Circle the appropriate response
Intellectual independence …………………………………...                               1        2        3        4
Capacity for analytical thinking …………………………….                            1        2        3        4
Ability to organize and express ideas orally ………………..                    1        2        3        4
Ability to organize and express ideas in writing ……………                   1        2        3        4
Initiative/self-direction ………………………………………                                1        2        3        4
Interpersonal skills …………………………………………..                                  1        2        3        4
Flexibility/adaptability ………………………………………                                 1        2        3        4
Dependability ……………………………………………….                                        1        2        3        4
Emotional stability ………………………………………….                                    1        2        3        4
Energy level ………………………………………………...                                       1        2        3        4
Application of knowledge to practical situations …………...                 1        2        3        4
Appreciation for/understanding of human diversity ………..                  1        2        3        4
Potential for success as a graduate social worker …………..                 1        2        3        4



How long have you known the applicant? ________ In what capacity? _______________________

Please add any further information that would help us evaluate this candidate: (Add separate pages if
needed)
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________

Summary statement: This applicant has         _____   My highest recommendation
                                              _____   My recommendation with confidence
                                              _____   My recommendation with reservation
                                              _____   I cannot recommend this applicant



______________________________________                 _________________________________________
Signature                    Date                      Position

______________________________________                 _________________________________________
E-mail address                                         Institution

								
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