Recommendation Form

RECOMMENDATION FORM

TO THE APPLICANT:

Please complete the initial portion of this recommendation form and then provide this recommendation form to three people, at least two of whom know you professionally. Have the recommender complete the form, place in an envelope, provide signature over the seal, and return to you. You will collect all materials and send the entire application packet to the Professional Counseling Program per the application instructions.

YOUR FULL NAME: ____________________________ SS#: _______________

EMAIL ADDRESS: ______________________________________________________

STREET ADDRESS: _________________________________ ___________________

CITY/STATE/ZIP: _______________________________________________________

TELEPHONE NUMBER: __________________________________________________

EXPECTED ENROLLMENT: ____ FALL ____ SPRING ____ SUMMER _________ YEAR

I hereby waive my rights to read this recommendation.

____ yes ____ no

_______________________________________ _______________

Signature Date

TO THE RECOMMENDER:

The person whose name appears above is applying for admission to the Graduate Professional Counseling Program at Texas State University-San Marcos. The applicant has requested that your recommendation be included as part of the information to be used in the admission process. We request that the applicant waive their rights to read this recommendation (see above).

Instructions: Please complete this recommendation form in its entirety, put the completed form in an envelope, and then sign your name across the seal. Please return the recommendation form to the applicant so that they can include it in their complete application packet.

Name of Recommender: ________________________________________________

Position or Title: ________________________________________________

1. How long have you known the applicant and in what capacity?

____________________________________________________________________________________

2. What characteristics do you consider to be talents and strengths of the applicant?

____________________________________________________________________________________

3. What characteristics do you consider to be limitations of the applicant?

____________________________________________________________________________________

4. How thoroughly do you think the applicant has considered plans for graduate study?

____________________________________________________________________________________

Please provide any additional comments that you believe would be helpful in assessing the candidate’s application for graduate work in counseling at Texas State University-San Marcos. Please use the back if necessary.

____________________________________________________________________________________

Please evaluate the applicant’s qualifications by checking the appropriate column. Check the group to which you are comparing the applicant’s abilities:

____Undergraduates ____Graduate Students ____Professional Educators

____ Other (Please specify) ___________________________________________

Qualifications	Superior	Good	Average	Poor	No Rating
Sensitivity to and awareness of cultural and gender diversity
Intellectual ability
Oral expression
Written expression
Interpersonal skills
Perseverance
General ethical behavior
Initiative
Creativity
Potential for counseling profession
Commitment to counseling profession
Ability to tolerate ambiguity
Interest in welfare of others
Awareness of strengths
Awareness of limitations
Willingness to be open and vulnerable
Sense of humor
Genuineness
Ability to receive and integrate feedback
Ability to form effective interpersonal individual relationships
Ability to form effective interpersonal small group relationships
Demonstrated ability for personal self-development
Demonstrated ability for professional self-development
Potential to conduct and interpret research
Technological competence & computer literacy

This space is provided for you to write your personal evaluative statement about the applicant’s potential to pursue graduate study in counseling
Please provide whatever relevant information you feel may be helpful to the Admission Committee.

____________________________________________________________________________________

Do you recommend this applicant to Texas State University-San Marcos?

____ Highly recommend

____ Recommend

____ Recommend with reservation

____ Do not recommend

Name of Recommender: ________________________________________________

Street Address: ________________________________________________

City/State/Zip: ________________________________________________

Email (optional): ________________________________________________

___________________________________________________ _________________

Signature of Recommender Date

Revised January 2007