Reference Form | Master of Science in Nursing

Program of Study:

Evaluator's Name:

Evaluator's Email:

Applicant's Name:

Relationship to Applicant:

Evaluator's Address:

Evaluator's Employer:

Evaluator's Phone Number:

Evaluator's Title:

Rate the candidate in each of the following six areas by selecting the best adjective:

1. Adaptability:

2. Communication Skills:

3. Team Orientation:

4. Dependablity:

5. Initiative:

6. Leadership:

Please provide a narrative appraisal of the candidate’s ability to complete a master’s level program.

Candidate's ability to complete program:

If this person were to apply for a job at your company, would you hire them?:

Yes
No

Why or why not?:

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