Department of Psychology
151 Martin Hall
Cheney, WA 99004-2423
Voice: (509) 359-2478
Fax: (509) 359-6325

DEPARTMENT OF PSYCHOLOGY LETTER OF RECOMMENDATION

PART I

TO THE STUDENT; Complete Part I. Give this form to the person recommending you.

Name of Applicant ______MS in Psychology: Clinical ____ General/Experimental ____

Please list courses you have taken from the person filling out the reference.

Course Level Course Title/Description When Taken Grade

(F, So, J, S, G)

Please list other personal contacts you have had with the person giving reference

Under the Family Educational Rights and Privacy Act, students of Eastern Washington University have the right to inspect their files upon request. So that the person you have requested to write a letter of recommendation will know if their letter will be held in confidence or if the letter will be open to your inspection upon your request, would you please sign one of the following statements. The waiving-of your right to see this letter of recommendation is not a requirement for admission or consideration for an award. (CHOOSE ONE OR THE OTHER)
I understand that I have the right to inspect my file upon I DO NOT WAIVE my right of access to
request under the Family Educational Rights and Privacy to this letter of recommendation.
Act. I hereby WAIVE my right of access to this letter of
recommendation.
Signature of Applicant Signature of Applicant

TO PERSON FURNISHING REFERENCE: Please fill out this form and forward it as soon as possible to the address

at the bottom of second page. If you have been asked to write a character reference or have included a letter, please disregard any part of this form that does not apply. If you do not know the student well, please feel free to indicate this. Such frankness will not prejudice the candidate's application for admission.

I do not know the student well enough to give a recommendation.

1. Please compare the applicant in the scale below with a representative group of students whom you have known during your professional career (please specify the reference group you are using, e.g., seniors, first-year graduate students, employees, etc.): Reference group ____

Outstanding Excellent Good Average Poor Unable to

(Top 5%) (Top 20%) (Top 30%) (Middle 40%) (Bottom 30%) make a

judgement

Intellectual

ability

Ability to work

with others

Ability to work

independently

Emotional Stability

and maturity

Overall potential

2. In what capacity and during what periods have you known this applicant?

3. What contributions has the student made on the campus? In the community?

4. How does this student's manner, attitude, and appearance affect you?

5. Some gifted individuals achieve marginal scholastic records. In your opinion is the applicant's scholastic record, as you know it, an accurate index of his scholastic ability? ___ Yes ___ No ____ Do not know. If your answer is no, please explain briefly, giving consideration to the applicant's performance in independent study or in research participation programs

6. Do you know of any factors related to character and responsibility or to physical and mental health which should be considered by the admissions committee or should be taken into account in planning for the student's graduate work? Please explain.

7. What is your estimate of the applicant's promise as a graduate student? (Give views on such matters as previous accomplishments; intellectual independence; capacity for analytical thinking; ability to work with others; ability to organize and express ideas clearly, orally and in writing; drive and motivation; quantitative ability; special skills or experience).

8. We will appreciate any additional statements you may wish to make concerning this candidate.

Signature Date

Name (Typed or Printed)

Address

Institution or business

Please return to: Admissions Committee

Department of Psychology

151 Martin Hall

Eastern Washington University

Cheney, Washington 99004-2431

DEADLINE: March 1