Philadelphia College Of Osteopathic Medicine

ADVERTISEMENT

r ec o m m e n D ation form
Philadelphia
Program aPPlying for:
College of
o Doctor of Psychology in Clinical
o Certificate of Advanced Graduate Studies
Osteopathic
Psychology (PsyD)
(CAGS)
Medicine
o Doctor of Psychology in School
o Applied Behavior Analysis
Psychology (PsyD)
o Cognitive Behavior Therapy
o Master of Science in School Psychology (MS)
o Organizational Development and
Department
o Educational Specialist in School
Leadership
Psychology (EdS)
o Professional Psychology
of Psychology
o Master of Science in Counseling and
o Certificate of Graduate Studies (CGS)
Clinical Health Psychology (MS)
o Applied Behavior Analysis
o Master of Science in Mental Health
o Respecialization in Clinical Psychology
Counseling (MS)
o Respecialization in School Psychology
o Master of Science in Aging and Long Term
o Post-Doctoral Certificate in Clinical
Care Administration (MS)
Health Psychology
o Post-Doctoral Certificate in
Neuropsychology
to the aPPlicant:
The Federal Family Educational Rights and Privacy Act of 1974 states that students are entitled
to review their records, including letters of recommendation. However, those writing recommen-
dations and those assessing them may attach more significance to them if it is known that the
contents will remain confidential. It is your option to waive or retain the right to review your
recommendations. Please indicate your choice and sign below.
o I waive my right to review this recommendation.
o I do not waive my right to review this recommendation.
_________________________________________
____________________________
Signature
Date
to the evaluator:
_______________________________________________ is applying for admission to
Philadelphia College of Osteopathic Medicine. We are interested in your evaluation of his/her
potential for graduate work, particularly intellectual ability, expressive ability (verbal and written),
maturity, emotional stability, integrity, motivation and ethical standards.
Please submit a letter of recommendation AND this completed form, to the PCOM
Office of Admissions via mail or email.
____________________________________________________________________________
Evaluator’s Name
Title
Institution/Organization
____________________________________________________________________________
Evaluator’s Signature
I have known the applicant for
_______ years
_______ months
I have known the applicant as a(n): o graduate student
o undergraduate
o peer/professional
o other (please specify)
_____________________
_____________________
PCOM
Office of Admissions
I know the applicant:
o slightly
o fairly well
o very well
4170 City Avenue
The population with which I am comparing this applicant consists of:
Philadelphia, PA
19131-1694
o undergraduate students I have taught/known o graduate students I have taught/known
recommend@pcom.edu
o colleagues I have worked with
o people I have supervised

ADVERTISEMENT

00 votes

Related Articles

Related forms

Related Categories

Parent category: Letters
Go
Page of 2