Fillable Recommendation Form printable pdf download

Recommendation Form

INSTRUCTIONS TO THE APPLICANT: Read and complete this section and provide it to your recommender along with a self-

addressed, stamped envelope. The recommender must return the completed recommendation to you in the sealed envelope for submission,

unopened, with your supporting documents packet. Or, the recommender may mail the recommendation directly to the UM-SSW Office of

Student Services. The recommender must sign across the seal of the envelope. Sign only if you are waiving access as specified below.

Under the provisions of the Family and Educational Rights and Privacy Act (FERPA), and applicable state law, you (if admitted and

enrolled) will have access to the information provided below unless you waive such access.

I hereby waive my right of access to the information contained in this recommendation.

Signature of Applicant

Date

IF THERE IS NO SIGNATURE ABOVE

THIS RECOMMENDATION WILL BE TREATED AS NON

CONFIDENTIAL

________________________________________________________

__________________________________________________

Applicant’s Full Name (Please Print)

Recommender's Name (Please Print)

________________________________________________________

Applicant’s Social Security Number or UM ID#

INSTRUCTIONS TO RECOMMENDER: The person named above is seeking admission to the Master of Social Work Program at the

University of Michigan. Individuals who are accepted must be able to fulfill the intellectual requirements of the School and should possess

personal qualifications essential to professional practice in social work. We greatly appreciate your assistance in our evaluation of this

candidate. Please place this completed form and any accompanying letter(s) in the envelope provided by the applicant, seal, and sign across the

seal. The applicant will submit the sealed envelope containing your recommendation to us as part of the application process.

How long have you known the applicant? __________________________________________________________________________

In what capacities have you known the applicant? (please check the appropriate boxes)

Professor

Research Supervisor

Academic Advisor

Supervisor

Field Instructor

Personal

Other

Using as a base of comparison other individuals whom you have known in the same field in recent years, please indicate your evaluation of

this applicant's ability and professional competence by placing a "X " in the appropriate column.

Characteristic

Exceptional

Outstanding

Very Good

Good

No Basis

Upper 5%

Next 15%

Next 50%

for Judgment

Intellectual Capability

Leadership Skills

Sense of Responsibility

Ability to Work with People

Integrity

Ability to Adapt to New Situations

Ability to Make Sound Judgments

Ability in Oral Communication

Ability in Written Communication

Concern for the Well-being of Others

Motivation for Chosen Field

Recommendation Form

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