Fillable RECOMMENDATION FORM MASTER OF PUBLIC HEALTH (Indiana Wesleyan University, Marion)

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RECOMMENDATION FORM MASTER OF PUBLIC HEALTH (Indiana Wesleyan University, Marion)

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MASTER OF PUBLIC HEALTH
RECOMMENDATION FORM
INDIANA
WESLEYAN
UNIVERSITY
This section is to be completed by the applicant. Please type or print.
Name of Applicant___________________________________________ Social Security __________________________
Home Address (Street, R.R., or PO Box)_________________________________________________________________
City_________________________________________ State_______________ Zip_____________________________
Home Phone (_____) __________________________ Work Phone (_____) ___________________________
Cell Phone (_____) _____________________________
Primary Email Address ______________________________________________________________________________
The Family Education Rights and Privacy Act of 1974 and its amendments guarantees students access to certain academic
records. Students my, however, waive their right of access to recommendations. The applicant’s choice regarding this
recommendation is to be indicated below. Failure to sign will constitute acceptance of limited access.
I do not waive by rights to inspect the contents of the following recommendation.
Signature of Applicant_____________________________________________ Date_____________________
TO THE INDIVIDUAL SUBMITTING RECOMMENDATION: The individual above is applying for admission into the Master
of Public Health. We would be grateful for your frank and detailed evaluation of this applicant by providing answers to the
attached document. We are particularly interested in specific information concerning the applicant’s intellectual and personal
characteristics as well as performance that may relate to her or his suitability for the study and practice of athletic training.
Thank you.
Please return completed form to:
Indiana Wesleyan University
Adult Enrollment Services
1900 West 50th Street
Marion, IN 46953
Phone: 866.498.4968 | Fax: 765.677.2601
INDIANA
WESLEYAN
UNIVERSITY
RECOMMENDATION
This section is to be completed by reference respondent. (Note: Confidentiality of recommendations cannot be guaranteed unless applicant waives right of access.)
Directions to Respondent: The person named above is applying for admission to Indiana Wesleyan University. Please indicate
(X) applicant ability and professional competence in comparison with other individuals whom you have known at similar
stages in their careers.
Please (X) the appropriate box
Outstanding
Top 10%
Very Good
Upper 25%
Average Below Average Above Average
Inadequate
Opportunity to
Observe or
Assess
General knowledge of field
Interactions with others
Ability to work in a group
Problem-solving skills
Critical thinking skills
Personal responsibility
Ethical conduct
Oral communication skills
Written communication skills
Leadership skills
Motivation and initiative
Additional Comments:
INDIANA
WESLEYAN
UNIVERSITY
How long have you known applicant? __________________________
In what capacity have you known applicant? _____________________________________________________________
Please indicate your overall endorsement of the applicant for graduate studies:
Recommend highly Recommend Recommend with reservation
Name of Respondent _______________________________________________________________________________
(Please print or type)
Relationship to Applicant:
Former Instructor Direct Supervisor
Pastor Co-Worker
Position/ Title____________________________________________________________________________________
Institution/ Organization ___________________________________________________________________________
Home Address (Street, R.R., or PO Box)_________________________________________________________________
City_______________________________________________ State________________ Zip______________________
Primary Email Address______________________________________________________________________________
Home Phone (______)_____________________________ Work Phone (______)___________________________
Cell Phone (______)_______________________________ Fax (______)__________________________________
Signature_______________________________________________ Date_____________________________________
indwes.edu | 866.498.4968
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RECOMMENDATION FORM MASTER OF PUBLIC HEALTH (Indiana Wesleyan University, Marion)

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Completed 21 August 2020

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