ࡱ> 5@ bjbj22 jXX $,)%)')')')')')')$\*R, K)]#]#]#K)`)]$]$]$]# %)]$]#%)]$<]$$$ 7HF8g#F$$dv)0)$-#-$-$(]$ [!K)K)S$  DEPARTMENT OF CHEMISTRY WICHITA STATE UNIVERSITY Reference Letter TO THE APPLICANT: Please give this form to a person familiar with your academic record and with your plans for graduate student. Provide a stamped envelope, addressed to Chair, Graduate Affairs Committee, Department of Chemistry, University, 1845 Fairmount, Wichita, KS 67260-0051. Applicant Name (last) (first) (middle) Present Address Present Occupation Employer Degree Sought Major Expected Date of Entry Concentration within Major The Family Education Rights and Privacy Act of 1974, effective January 1, 1973, provides that an applicant admitted o an enrolled in is entitled to review his/her record on file in the department office. If an applicant wishes personal appraisals to , Dept. of Chemistry submitted on a confidential basis, this right of access may be waived. While confidential appraisals are no longer required of applicants, you may wish this form to remain confidential. If so, please sign below. Applicants Signature Date  TO THE RATER: The applicant named above is making preliminary application to graduate student at the University, Department of Chemistry, and has asked that you rate his/her ability, background, and personality. Your cooperation in making these ratings will assist us in evaluating the applicant. Please mail the completed form in the enclosed stamped, addressed envelope. If the applicant has not waived his/her right to review this rating sheet, you should consider the rating sheet as non-confidential, and, of course, you are at liberty to return the form uncompleted. Your attention is directed to the applicants signature and intention above. 1. How long have you known the applicant and in what capacity? (Give dates, if possible). 2. Please rate the applicant in each area listed below in comparison to others you have known. No Basis to JudgeUpper 5%Upper 10%Upper 25%Upper 50%Lower 50%Intellectual Ability/CuriosityAbility to Express Self OrallyAbility to Express Self in WritingMotivation/PerseveranceAbility to Work with OthersEmotional Maturity and StabilityDependabilityInitiativeFlexibility/CreativityOpen MindednessAbility to ReasonOverall Potential 3. (For teachers of applicant only) I would rank this applicant in the top _____% of approximately ______ undergraduate or _______ graduate students I have taught in _____ years. 4. Estimate of Potential: OutstandingAbove AverageAverageBelow AverageAs researcherAs Masters CandidateAs Doctoral Candidate 5. Recommendation concerning admission (check one) _____ I recommend the applicant without reservation. _____ I recommend the applicant with confidence. _____ I recommend the applicant with reservation. (Please explain in Item #6). _____ I do not recommend the applicant. (Please explain in Item #6). 6. Please give your best assessment of the applicants chances for success in graduate school. Include any particular strengths which he/she possesses, as well as any weaknesses. We appreciate your candid appraisal. 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