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Mental Health Scholars Academy Letter of Recommendation Form

Applicant
Information about the Mental Health Scholars Academy applicant.
Applicant Name:

Degree Program:

Mental Health Scholars Academy program website:
Evaluation
The person named above has made application for graduate study and tuition support through the Mental Health Scholars Academy (MHSA). We would greatly appreciate your candid appraisal of the applicant.
How long have you known the applicant?*
In what capacity?*
Note: Please be as specific as possible (e.g. professor, manager, supervisor, mentor, etc.).
Please provide a rating (Outstanding, Superior, Good, Fair, Poor, Unable to judge) based on your perception of the candidate for the following characteristics:
Self-Motivation*
Outstanding Superior Good Fair Poor Unable to judge
Emotional Intelligence*
Outstanding Superior Good Fair Poor Unable to judge
Professionalism*
Outstanding Superior Good Fair Poor Unable to judge
Judgment and Decision-making*
Outstanding Superior Good Fair Poor Unable to judge
Academic Preparedness*
(e.g. writing, aptitude, timeliness, critical thinking, etc.)
Outstanding Superior Good Fair Poor Unable to judge
Time Management and Organization Skills*
Outstanding Superior Good Fair Poor Unable to judge
Empathy and Concern for Others*
Outstanding Superior Good Fair Poor Unable to judge
In 3-4 sentences, please describe why this person is a good candidate for the Mental Health Scholars Academy (please include any special qualities, skills, academic preparedness, or qualifications that contribute to your recommendation).*
What are this candidate’s strengths?*
What would you consider to be the candidate's areas of growth and weakness?*
What is your overall recommendation?*
- Strongly recommend
- Recommend
- Recommend with some reservation (please explain)
- Do not recommend (please explain)
Please explain your overall recommendation:*
Recommender
Name*
First Last
Email Address*
Recommender's Title/Position*
Phone Number*
Institution/Organization Name*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Electronic Signature*
I Agree
I hereby certify that the information I am submitting is complete and accurate. I understand that checking "I Agree" above acts as my signature on this form.
Date*
Date Format: MM slash DD slash YYYY

Enter today's date.
Email
This field is for validation purposes and should be left unchanged.

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