Fillable Medicine Applicant Evaluation Form printable pdf download

TEXAS A&M UNIVERSITY

COLLEGE OF VETERINARY MEDICINE

APPLICANT EVALUATION

Applicant: Enter your name and other contact information as well as sign statement A or B below before giving this form to an

evaluator.

Name of Applicant

Telephone ____________________

TMDSAS Applicant ID# __________________________________

Email: _______________________________

Name of Evaluator: _____________________________________ Telephone __________________________________

Evaluator’s Title or Occupation _________________________________________________________________________

Institution, Practice, or Place of Business__________________________________________________________________

Evaluator’s Address___________________________________________________________________________________

Street

City

State

Zip Code

E-mail _____________________________________________________________________________________________

_____________________________________________________________________________________________________________

TEXAS A&M UNIVERSITY EQUAL OPPORTUNITY STATEMENT

Texas A&M University is an equal access/equal opportunity institution. As such, we do not discriminate on the basis of race, ethnic

background, religion, disability, age, gender, or sexual orientation.

TO THE PRE-HEALTH ADVISOR: Texas A&M University, College of Veterinary Medicine and Biomedical Sciences only requires

an evaluation to be submitted. Seal the form(s) in an institutional or business envelope and sign across the back seal. If your school

has a policy, which forbids you to release sealed evaluations to the applicant, you may mail the evaluation(s) directly to: TMDSAS:

P.O. Box 2175 Austin, TX 78768. Deadline for submission: October 1.

TO THE EVALUATOR: The above-named applicant has requested that you evaluate him/her as a candidate for the professional

curriculum of the College of Veterinary Medicine and Biomedical Sciences at Texas A&M University. The information you provide will

be used only in the admissions process. You may be contacted by a member of the admissions committee seeking additional information

or verification. The candidate has indicated below whether or not he/she wishes to have access to this evaluation. Please place this

completed evaluation in a business envelope; seal, then sign the envelope across the back seal. Please forward the completed evaluation

to the Texas Medical and Dental Schools Application Service (see address above) or return the envelope to the applicant to be

forwarded. Deadline for submission: October 1.

1. How long have you known or observed the applicant? ________________________________________________________________

2. In what capacity have you known the applicant? ____________________________________________________________________

3. In the past five years, I have evaluated approximately ____________candidates for admission to veterinary medical colleges.

_____________________________________________________________________________________________________________

TO THE APPLICANT:

Applicants who are admitted have the right, under the family educational rights and privacy act of 1974, to see written evaluations

submitted on their behalf, unless they waive the right. Please indicate your choice by signing either statement A or B. The signing of this

waiver is voluntary and refusal to do so will not be a factor in considering your application.

A. I hereby waive my right of access to the applicant evaluation provided by the evaluator named above.

_____________________________________

_____________________

Applicant’s Signature

Date

B. I do not waive my right of access to the applicant evaluation provided by the evaluator named above. He or she should be made aware

that I retain my right of access and that the confidentiality of the evaluation is not guaranteed.

______________________________________

_______________________

Applicant’s Signature

Date

This waiver is effective insofar as the recommendation is used solely for the purpose of admission. However, because of variation in

State laws, this waiver may not be valid in every state nor can the confidentiality of this evaluation be guaranteed in every state.

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Medicine Applicant Evaluation Form

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