College of Graduate Studies

CONHS Doctoral Reference Form

College of Nursing and Health Sciences

Applicant's Information
* Student name:
* Student ID:   ('A' number)
Address:
City:
State:
Zip:
Phone:
Email:
* required information
Evaluator's Information

References should be professionals who are able to evaluate the applicant's performance as a practitioner.

* First name:
* Last name:
Address:
City:
State:
Zip:
Phone:
* Email:
Job Title:
* required information
Evaluation Please rate applicant on qualities below to the best of your knowledge
Individual characteristic Exceptional Above
Average
Average Below
Average
Independence of thought
Intellectual curiosity
Creative problem solving
Critical thinking
Reflective thought
Leadership ability
Oral expression
Written expression
Perseverance
Emotional maturity

*Please provide details in the additional information section if you rate an applicant as exceptional or below average on any characteristic.


How long have you known this applicant?

In what capacity do you know this applicant? Are you his/her co-worker, supervisor, etc.? What is your working/professional relationship with this applicant?

Please share any additional information about this applicant that might help us assess potential for success
        Clicking submit will email your request to gradweb@tamucc.edu.

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Please contact us with any issues or concerns at 361-825-2753, or via email at gradweb@tamucc.edu