Bishop State Community College
Physical Therapist Assistant Program
Letter of Reference
References Name: Day time Phone:
Position: Date Completed:
Department/Division:
Email Address: Address:
How long have you known this applicant?
How well do you know the applicant?
Approximately how many references will you submit on behalf of PTA applicants?
What organization were you associated with the when you interacted with the applicant?
What was your role in the organization?
Excellent
Good
Average
Below
Average
Poor
Not
Observed
Commitment to Learning
Interpersonal Skills
Communication Skills
Effective Use of Time
Responsibility
Critical Thinking
Stress Management
Problem Solving
Leadership
How do you think this person would perform as a physical therapist assistant?
o I highly recommend this applicant to the PTA Program a BSCC
o I recommend this applicant.
o I recommend this applicant, but with some reservations
o I am not able to recommend this applicant.
Comments: