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MSDA Applicant Reference Form
UH Downtown
College of Sciences & Technology
MSDA Applicant Reference Form
Coordinator of MS in Data Analytics
TO THE APPLICANT: Complete Section I below and forward this MSDA applicant reference form to the
individual (evaluator) who will provide the reference. Please advise the evaluator to submit the completed
MSDA applicant reference form in .pdf file format to gradadmissions@uhd.edu
. Upon receipt the MSDA
applicant reference form becomes the property of UHD and will not be returned. In addition, UHD reserves the
right to verify all MSDA applicant reference forms with the evaluator.
TO THE EVALUATOR:
Complete Section II and email the completed MSDA applicant reference form from
your email account in .pdf file format to gradadmissions@uhd.edu
. If you need to use additional pages submit
them in .pdf file format with the MSDA applicant reference form. Your candid completion of this MSDA
applicant reference form is greatly appreciated. You can be assured that this MSDA applicant reference form
is completely confidential and will not be shared with the applicant, provided the applicant has waived their
rights to review it.
_
SECTION I (to be completed by MSDA applicant)
Name: ________________________________________________________________________ Date of Birth ______/_____
Last First MI Month/ Day
Current Address________________________________________________________________________
________________________________________________________________________
ALL MSDA APPLICANTS MUST READ AND SIGN THIS AUTHORIZATION FOR WAIVER*:
I understand my right under the U. S. Family Educational Rights and Privacy Act of 1974 to review
confidential appraisals placed in my file that are submitted with reference to admission to a graduate
or other school.
I __ do __ do not (you must check one) waive my right to review this
MSDA applicant reference form.
Applicant’s Signature ____________________________________________ Date ___________________________
Agreeing to waive your right to review this MSDA applicant reference form is not required as a condition of
admission to the UHD MSDA program.
_
SECTION II
Name of evaluator ______________________________________________________________________________
The length of time you have known the applicant: _____ Years
The capacity in which you have known the applicant (check all that apply):
___ Employer / Supervisor
___ Professor
___ Other (please specify) ____________________________________________________.
What was the nature of the applicant’s duties (briefly describe)?
With whom are you comparing this applicant on the factors listed below (check only one)?
__ Employees I know with similar duties and education;
__ All persons reporting to me
