Honors Program Recommendations

Student

Student Name*Last, First, Middle

Teacher/Instructor’s (or Employer’s) Name*

Teacher/Instructor’s School (or Employer’s Firm)*

Teacher/Instructor/Employer’s Telephone Number*

Teacher/Instructor/Employer

What is your position or title?*

How long have you known the applicant?*

Please rate the above applicant in the following areas

Academic Ability

1 (Poor)

2 (Weak)

3 (Fair)

4 (Good)

5 (Excellent)

Not Observed

Ability to Work Independently

1 (Poor)

2 (Weak)

3 (Fair)

4 (Good)

5 (Excellent)

Not Observed

Ability to Work with Peers

1 (Poor)

2 (Weak)

3 (Fair)

4 (Good)

5 (Excellent)

Not Observed

Motivation

1 (Poor)

2 (Weak)

3 (Fair)

4 (Good)

5 (Excellent)

Not Observed

Self-directed Learner

1 (Poor)

2 (Weak)

3 (Fair)

4 (Good)

5 (Excellent)

Not Observed

Response to Challenges

1 (Poor)

2 (Weak)

3 (Fair)

4 (Good)

5 (Excellent)

Not Observed

Oral Communication Skills

1 (Poor)

2 (Weak)

3 (Fair)

4 (Good)

5 (Excellent)

Not Observed

Written Communication Skills

1 (Poor)

2 (Weak)

3 (Fair)

4 (Good)

5 (Excellent)

Not Observed

Please comment on areas in which this applicant excels.*

Please comment on areas that this applicant needs to strengthen.*

Additional Comments

Signature*

Date*