Character Recommendation Form

Thank you for helping us complete the admissions decision process by providing this reference. We value your comments and request that you give a full and candid report so that fair consideration may be given to the applicant. If you feel that you do not know the student well enough to give a complete reference, please refer the student to another person.

Your Contact Information

Your Name: *

Name of School/Organization: *

Position: *

Organization Telephone: *

Organization Address: *

City: *

State: *

Zip: *

Date: *

Applicant Information

Applicant's First Name: *

Applicant's Last Name: *

Applicant City: *

Applicant State: *

How long have you known the applicant?: *

How well do you know the applicant?: *

Very Close

Fairly Well

Casually

By name/sight

Please list the applicant's involvement in activities at your institution: *

Has the applicant ever been dismissed or suspended?: *

Yes

If yes, please explain dismissal or suspension:

How do you rate this person in the following areas?

Applicant ratings: *

	Excellent	Above average	Average	Below average	No chance to observe
Academic Ability
Anticipated Achievement in College
Communication Skills
Cooperativeness
Emotional Stability
Initiative and Motivation
Integrity and Honesty
Leadership
Responsibility
Social Adaptability

What specific encouragement, guidance, or supervision would you suggest?:

What additional information can you provide about this applicant that may help us in making our decision?:

To your knowledge, has the applicant used the following in the past year

Alcoholic beverages?: *

Yes

Tobacco?: *

Yes

Non-medical drugs?: *

Yes

Final Recommendation

Recommendation: *

I recommend this applicant

I recommend this applicant with reservation

I do not recommend this applicant