Department of Professional Counseling
Graduate Applicant
Recommendation Form
TO BE COMPLETED BY THE APPLICANT
Applicant's Full Name:
According to FERPA of 1974, students are guaranteed access to educational records concerning them, unless that
right is waived. Therefore, signing is optional. I hereby waive any and all rights to inspect and review this
recommendation, and I give my permission for this reference to remain confidential between Webster University and
the recommender. I also acknowledge that Webster University may contact the recommender for additional
information.
Signature: Date:
TO BE COMPLETED BY THE RECOMMENDER
Recommender Name
(Printed):
Title:
Phone: E-mail
How long have you
known the applicant
and in what capacity?
In addition to rating applicant characteristics on page 2 of this form, please address character traits, personality,
and scholastic ability related to their pursuance of graduate work in a professional counseling program. You may
also attach a letter, if desired:
Please Continue to Page 2
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This applicant is seeking admission to a Master's degree program in Counseling. Please rate the applicant on
the following items:
Excellent Good Fair Poor No Basis
for
Judgement
Aptitude and motivation for graduate-level
study
Oral communication skills
Writing communication skills
Ability to solve problems and make
decisions
Potential for conducting research
Work ethic and responsibility
Independence/initiative
Professionalism
Career goals related to counseling
Ability to receive constructive criticism
Ability to form culturally positive
interpersonal relationships
Leadership potential
Interpersonal skills including the ability to
work with others
Signature: Date:
SUBMISSION
Recommender, please send your recommendation via email: admprocessing@webster.edu (from your professional
email) OR via mail: Webster University Office of Admission, 470 E. Lockwood Ave, St. Louis, MO 63119 (with your
signature on the seal)
The Department of Professional Counseling at Webster University thanks you for your valued input!
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