RECOMMENDATION FOR APPLICATION TO THE
IUSB COUNSELING AND HUMAN SERVICES
MASTER OF SCIENCE DEGREE PROGRAM
________________________________
Applicant's Name
________________________________
Date
The individual who has submitted this
recommendation to you is seeking admission to the Master of Science
degree program in Counseling and Human Services at Indiana University
South Bend.
Your appraisal of
the applicant=s
aptitude for graduate study in the field of Counseling and Human
Services will provide assistance to the Graduate Faculty in determining
the applicant=s
potential success in the program.
This
recommendation form will be placed in the applicant=s
academic file at IUSB. The recommendation will not be considered
confidential information, so the applicant may request to review this
form.
Your time and
effort in completing this recommendation form are greatly appreciated.
Please return it directly to the address listed at the top of the form.
Thank you for your assistance.
Sincerely,
Todd Norris
Director, Education Student Services,
Graduate Advisor/Certification Officer
Please Return To:
Todd Norris
Director, Education Student
Services
Indiana University South Bend
1700 Mishawaka Avenue - GR120
South Bend, IN 46634-7111
|
INDIANA UNIVERSITY SOUTH BEND
SCHOOL OF EDUCATION
COUNSELING & HUMAN SERVICES
MASTERS DEGREE PROGRAM
RECOMMENDATION FORM
APPLICANT'S NAME:
DATE:
PLEASE RESPOND TO
EACH OF THE ITEMS BELOW:
1.
How long have you known the applicant?
2.
How well do you believe you know the applicant?
3.
What has been or is the current nature of your relationship to the
applicant? (e.g., instructor, supervisor, friend, etc.)
4.
Indicate the point on each of the following scales that you feel is
most indicative of the candidate.
Open to new ideas, changes
I___I___I___I___I
Closed to new ideas
1 2 3 4 5
Strong commitment to helping
I___I___I___I___I
Weak commitment to
professions
1 2
3 4 5
helping professions
Relates well with people
I___I___I___I___I
Relates poorly with people
1 2 3 4 5
ersonal goals are specific
I___I___I___I___I
Personal goals are vague
1 2 3 4 5
Genuine; no
facade I___I___I___I___I
Phony; lots of role-playing
1 2 3 4 5
Overall Recommendation:
Excellent potential for working
I___I___I___I___I
Poor potential for working in
in helping relationships
1 2 3 4 5
helping relationships
5.
Please provide your assessment of the candidate=s
strengths and weaknesses for entry into the professional graduate training
program in Counseling and Human Services. Please use the reverse side of
this form to complete your comments.
Name:
Signature:
(Printed/Typed)
Address:
City, State:
Zip: |
