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Graduate Programs Admission
Reference Request Form

Professional/work-related or academic-related references are required (do not use personal friends and/or family).  Reference must know applicant at least 6 months.

Completed by applicant

  1. Note to Applicant: 

    Please enter your name and Social Security number below. Be sure to review and complete, if appropriate, the section titled "Applicant's Waiver of Right to Access."

    1. Applicant Name  __________________________________________________
      (Last)
      (First)
      (MI)

    2. Social Security number_________________________

  2. Applicant's Waiver of Right to Access

    The Family Educational Rights and Privacy Act of 1974, as amended (P.L. 93-380), allows a candidate for admission to waive his or her right of access to confidential letters or statements written on his or her behalf if the recommendation is used solely for the purpose of admission and if the candidate, upon request, is notified of the names of all persons making such recommendations on his or her behalf. The University does not require such a waiver as a condition for admission. However, under the legislation, the applicant has the option of signing such a waiver as follows:

    1. I hereby waive my right of access to this recommendation and any appropriate attachments that have been written by (name of recommender) ____________________________ , on behalf of my application for admission to the Franklin University Graduate Program. This waiver is effective insofar as the recommendation is used solely for the purpose of admission.

      Applicant name ___________________________________

      Signature ______________________________________

      Date ________________

    Completed by recommender

  3. Note to Recommender:

    The person whose name appears above is applying for admission to the Franklin University Graduate Program. Your candid assessment of the applicant will greatly assist us in making a decision that is good for both the applicant and the Program. Federal law may require that your letter be shown to the applicant. Please refer to the section above titled "Applicant's Waiver of Right to Access." We appreciate the time and effort you are making to provide us with this information.

    1. I have known the applicant for approximately ______ years ______ months
      (Note: Recommender must know Applicant for at least six months.)

    2. Define the nature of your relationship to the individual who applying to the Graduate Program.

      The relationship was/is (check all that apply):

      Professional

      Academic (Please list the courses this individual completed)

      Course name ________________________________________

      When taken __________________________ Grade _________

      Other (Explain) ______________________________________

    3. What do you consider to be the applicant's strengths or talents?

      ______________________________________________________

      ______________________________________________________

      ______________________________________________________

      ______________________________________________________

    4. What do you consider to be the applicant's weaknesses or challenges?

      ______________________________________________________

      ______________________________________________________

      ______________________________________________________

      ______________________________________________________

    5. How will a graduate education help the applicant realize his or her goals?
      ______________________________________________________

      ______________________________________________________

      ______________________________________________________

      ______________________________________________________

    6. Please give us your appraisal of the applicant in terms of the qualities listed below. Rate the applicant in comparison to other graduate program applicants whom you have known or "fast management track" persons within your organization.

      Top 5%
      Exceptional
      Top 25%
      Above Average

      Average
      Lower 25%
      Below Average
      Not
      Observed
      Integrity
      Motivation: willingness to work intensely toward goals
      Ability to work with others
      Ability to manage time wisely
      Analytical ability: problem recognition, structuring and solving
      Ability in oral expression

    7. Please feel free to comment on the ratings you assigned in section F and to make an additional statement about the applicant's record, potential or personal qualities that will help us reach a decision.

      ______________________________________________________

      ______________________________________________________

      ______________________________________________________

      ______________________________________________________

    8. I would:

      strongly recommend recommend
      recommend with reservations not recommend

      this applicant for adminission into a Franklin University Graduate Program.

    Reference's signature ______________________________________

    Date _______________________

    Reference's name (please print) ______________________________

    Highest level of education completed:

    Ph.D.    Master's    Bachelor's    Associate's    Other

    Title _______________________________________________________

    Organization ________________________________________________

    Address ___________________________________________________

    __________________________________________________________

    City ________________________ State _____ Zip _________________

    Phone _____________________________________________________

    Email Address _______________________________________________

    Please return this Reference Request as quickly as possible to:
    Franklin University Graduate Admissions & Services
    201 S. Grant Ave.
    Columbus, OH 43215
    or fax to 614.947.6771