Download CUhonors-Faculty-Reference-form-jan2016

Clemson University School of Nursing
Departmental Honors Program Reference Form
STUDENT NAME: _______________________
EVALUATOR NAME: ____________________________
Each applicant into the Undergraduate Nursing Honors program at Clemson University is
required to submit two references from current or previous instructors. The Honors Department
would like to receive an honest assessment of the applicant’s character, personality, and work
ethic. This information is crucial to selecting applicants for the Honors Program. All reference
forms are confidential. This form is to be completed by the faculty evaluator and can be
submitted electronically directly to Nancy Meehan ([email protected]).
Please place a  under the column that gives the most accurate description of the applicant’s
qualities. A comments section is included if any further explanation is needed regarding the
applicant’s abilities to succeed in the honors program.
Excellent
Above
Average
Average
Below
Average
Poor
N/A
Capacity for Independent Thinking –
curiosity, creativity, leadership
Communication – verbal and written
clarity, coherence
Critical Thinking – ability to problem
solve in a creative manner
Time Management – punctual, meets
deadlines/due dates
Work Habits and Self-reflection –
motivation, self-discipline, resourceful,
conscientious, organization, initiation, and
independently completes assignments
Reliability – honest and dependable
Attitude and Personality – cooperative,
confident, courteous, poise
Overall potential for scholarly work
Comments:
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
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