Master of Science in Counseling Psychology Recommendation Form
Address
Applicant’s Undergraduate School
Name of Applicant
Please use full name:
Applicant should complete the following:
To the Applicant
To the Person Providing Reference
Please complete and return this form to:
Waiver of Access
I have requested that this report be filed by school officials for use in the admissions process by officials of Angelo State University. In accordance
with the Family Educational Rights and Privacy Act of 1974, I have indicated my intention regarding access to these reports by checking one of the
following options:
I waive access to this report which shall therefore be considered confidential.
I do not waive access to this report.
Date: __________________________________________ Signature: _______________________________________________________
Note to Person Providing Reference: If the student has agreed to the waiver printed above, we will preserve the strict confidentiality of this
document and it will be made available only to University officials. If the student has not agreed, this report will be made available to the student
upon request, if the student matriculates at Angelo State University.
We ask that you provide at least two references according to the following guidelines:
1.
Two of the three references must be from academic sources, preferably faculty with whom you have worked closely.
2.
The
third reference may be non-academic, but should be someone that can comment on skills and abilities relevant to graduate
school. Examples of unacceptable references would be: parents, pastors, friends or peers, relatives, etc.
The information that you supply concerning this applicant will be used in the screening and final ranking of applications. No application
will be considered without this information. Your cooperation is appreciated.
Your Name: ______________________________________________ In what capacity do you know the applicant? _______________
Address: _________________________________________________ ___________________________________________________
How long have you known the applicant? _______________________ Title: ______________________________________________
Email address: _____________________________________________ Telephone Number:* (____) ____________________________
* May we contact you for additional information, if needed?
Yes No
ANGELO STATE UNIVERSITY
Master of Science in Counseling Psychology Program
ASU Station #10922 • San Angelo, Texas 76909
Phone 325-486-6932 • Fax 325-942-2194 • Email: drew.curtis@angelo.edu • www.angelo.edu/dept/psychology_sociology
COLLEGE OF GRADUATE STUDIES
CID# or SS#
Please attach a recommendation letter explaining why you believe this candidate would be successful in the program. Please
focus on the student's ability to think critically and write effectively, their experiences that will prepare them for the
curriculum, their ability to work personally and professionally as a counselor, and other issues that would be helpful in
making our admissions decision.
Signature Date
College of Graduate Studies
Angelo State University
ASU Station #11025
San Angelo, TX 76909-1025
graduate.studies@angelo.edu
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