MLS Program Recommendation Form

Please rate the applicant's skill or aptitude for each of these traits.

Rows	LOW	AVERAGE	HIGH
MOTIVATION: desire to increase their contribution to the organization and to society in general
INITIATIVE: capability as reflected by work; self-starting
LEADERSHIP: ability to plan and work with others and effectively direct activities
CONCERN FOR OTHERS: consideration of others’ feelings and ability to view all parameters of circumstances
RESPONSIBILITY: ability to assume accountability for inherent burdens of work and society
INTEGRITY: adherence to honesty in dealings with others
EMOTIONAL STABILITY: ability to react under stress in a mature and dependable manner
ADAPTABILITY: ability to work with and under directions of others
APPEARANCE: neatness in person and dress
APPLICATION OF ACQUIRED SKILLS: ability to learn and perform tasks
ATTENDANCE: reliability to be at designated functions and to be on time
INTERPERSONAL RELATIONSHIPS: ability to establish and maintain effective relationships with others

Please rate the student on each of the following statements using a scale of 1-4 with 4 representing excellent.
Uses logical thought processes
Able to transfer information
Learns from mistakes
Please give any additional information you feel might be helpful in evaluation of this applicant.
Summary Recommendation

Please answer the following questions about yourself and your relationship to the applicant.
How many years have you known this applicant?
What is your relationship to the applicant?
What is your occupation?
Name of recommender
Name

First NameLast Name
Professional Title
Address

Street Address

Street Address Line 2
CityStateZip Code
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Should be Empty: