A. TO BE COMPLETED BY APPLICANT
Instructions: Two recommendations are required from past faculty and/or supervisor. Complete Section A prior to giving this form and a self-addressed envelope to each rater. Only these forms will be accepted as official recommendations. Letters of support from raters are welcome. All completed forms should be mailed by the rater to the applicant.
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Applicant’s Name: (please print) |
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SSN: |
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Street Address: |
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City: State: Zip Code: |
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Day-time Phone: ( ) Home Phone: ( ) |
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Rater’s Name: (please print)______________________________ Check if: ____ Employer ____ Academic Professor
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Initial the desired response and sign below. [ ] I waive my right to review this recommendation form and/or or any attached letters. [ ] I do not waive my right to review this recommendation form and/or any attached letters. Applicant’s Signature:___________________________________ Today’s Date: ___________________ |
B. TO BE COMPLETED BY RATER
Instructions: Thank you for investing the time and effort to complete this form. We are aware of the time involved but assure you that recommendations play a vital role in our admissions decisions. In an effort to be as uniform and meaningful as possible in our admissions process, we have devised this form. Additional comments and attachments in support of your ratings are welcome. Completed forms should be sealed in an envelope with your signature across the flap. Mail the sealed envelope directly to the applicant. Thank you for your assistance in the admissions process.
For Sections I through IV, rate the strength of this applicant on a sliding scale of “1 to 7”. (see below)
1 2 3 4 5 6 7
Weakest Average Strongest
I. PERSONALITY TRAITS
( ) CREATIVITY – views things from multiple perspectives
( ) SENSITIVITY – read cues, both verbal and non-verbal, from others
( ) RESPONSIVENESS – reacts constructively to cues, both verbal and non-verbal, from others
( ) WARMTH – shows positive and approachable manner
( ) ENJOYMENT – shows pleasure and joy from actions, occupations or life in general
( ) ACHIEVEMENT ORIENTATION – demonstrates a “CAN DO” attitude
( ) OCCUPATIONAL PERFORMANCE – invests in and understands an occupation of particular interest to them such as the arts, school work, sports
II. PROFESSIONAL ATTITUDE
( ) WILLINGNESS TO ACCEPT RESPONSIBILITY – accepts appropriate level of responsibility for his/her actions
( ) ETHICAL SENSITIVITY – shows awareness of and behaves in an ethical manner
( ) SELF MOTIVATION – shows awareness of his/her own behavior and its effect on others
( ) CONFIDENCE – shows confidence in his/her own judgment, ability to learn and perform
( ) CAREER COMMITMENT – committed to pursuing a career in nursing.
III. PROFESSIONAL JUDGMENT
( ) PROBLEM SETTING – identifies and defines problems
( ) REALISTIC UNDERSTANDING – realistically evaluates multiple solutions
( ) SYNTHESIS – combines information from several sources when solving problems
IV. PROFESSIONAL PERFORMANCE
( ) ABILITY TO WORK COLLABORATIVELY – effectiveness in coordinating work with others
( ) ABILITY TO WORK INDEPENDENTLY – functions competently without close supervision
( ) ORGANIZATION – plans work and manages time productively
( ) ORAL EXPRESSION – expresses thoughts verbally in a clear and organized way
( ) WRITTEN EXPRESSION – writing shows clear expression and use of accepted language skills
GRAND TOTAL OF POINTS_________
V. COMMENTS
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VI. IDENTIFICATION OF RATER
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NAME AND TITLE: (please print) |
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FACILITY: |
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STREET ADDRESS |
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CITY: STATE: ZIP CODE: |
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HOW LONG HAVE YOU KNOWN THE APPLICANT? |
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IN WHAT CAPACITY HAVE YOU KNOWN THE APPLICANT? |
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RATER’S SIGNATURE: TODAY’S DATE: |
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DAY-TIME PHONE: ( ) |
Please send ALL recommendations to:
Shenandoah University
Office of Admissions
1460 University Drive
Winchester, VA 22601
Revised: 1/25/07