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Undergraduate - Nursing Reference Report
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This form is to be completed by the reference writer.
Due to federal legislation giving students access to educational records, we cannot guarantee the confidentiality of this document unless the applicant has signed a waiver. Please complete this document to the best of your ability.
If you have any questions please contact the undergraduate admissions office at admission@sunypoly.edu or by phone at 315-792-7500
Applicant First Name:
Applicant Last Name:
Reference First Name
Reference Last Name
Reference Email Address
Confirm Reference Email
Please rate the applicant compared to his/her peers on the following:
Ability to grasp new concepts
Excellent
Above Average
Average
Poor
Unable to Rate
Ability to grasp new concepts
Intellectual creativity
Intellectual creativity
Retention of information
Retention of information
Ability to analyze problems, formulate solutions
Ability to analyze problems, formulate solutions
Written communication skills
Written communication skills
Oral communication skills
Oral communication skills
Ability to work under pressure
Ability to work under pressure
Ability to work effectively with others
Ability to work effectively with others
In what capacity do you know the applicant?
In what capacity do you know the applicant?
Professor/Instructor
Employer/Supervisor
Colleague/Co-worker
Academic Adviser
Other
Please explain
How long have you known the applicant?
How well do you know the applicant?
Very well
Moderately well
Slightly
How well do you know the applicant?
What are the applicant's primary areas of strength?
What are the applicant's primary areas of weakness?
What is your overall evaluation of the applicant’s ability for success in graduate school?
Submit
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