SOUTHERN UTAH UNIVERSITY
APPLICATION TO THE DEPARTMENT OF NURSING
BACHELOR OF SCIENCE IN NURSING – BSN DEGREE PROGRAM – Fall 2020 Admission
SUU Department of Nursing – Admissions, 351 W. University Boulevard,
Cedar City, UT 84720, 435/586-1906, RobertsonV@suu.edu
SECTION 4
Evaluators should: (1) rate each statement independently, and (2) avoid a tendency to rate on general impressions. One
characteristic might influence the rating of all characteristics.
The following questions or statements identify a variety of traits, skills, attitudes, etc. Please indicate the degree to which
each quality is characteristic of the applicant you are rating by: (1) reading the statement carefully, (2) reading the points on
the scale, and (3) encircling the number of your choice on the scale.
Specific comments in each category are encouraged. If you do not feel that you have enough information to rate the
candidate on a particular item, please circle “UNABLE TO ASSESS”.
1. Problem Solving: Ability to identify and solve problems:
1 2 3 4 5
UNABLE TO ASSESS
Poor Average Excellent
2. Sense of Responsibility: Ability to complete tasks, duties & honors commitments:
1 2 3 4 5
UNABLE TO ASSESS
Doesn’t complete; Average Always completes;
Avoids responsibility Accepts responsibility
3. Maturity: Ability to conduct self in a mature, adult manner:
1 2 3 4 5
UNABLE TO ASSESS
Immature, childish Average Mature, adult behavior
4. Attitude: Based upon your experience, what type of attitude does the applicant project toward life, school, job, etc.
1 2 3 4 5
UNABLE TO ASSESS
Very negative Average Very positive
5. Caring Attitude: Does the applicant display a degree of caring for others?
1 2 3 4 5
UNABLE TO ASSESS
Very little Average Exceptional
6. Stress/Anxiety Response: Ability to deal with stressful, anxiety-producing situations:
1 2 3 4 5
UNABLE TO ASSESS
Poorly, ineffective Average Excellent
7. Motivation: Extent to which individual applies self:
1 2 3 4 5
UNABLE TO ASSESS
Uninspired Average Self-starter;
Systematically a hard worker
8. Appearance: Extent to which standards of appearance are met:
1 2 3 4 5
UNABLE TO ASSESS
Untidy Average Well groomed
Page 2 of 3