Reference for Candidacy Form Reference for Candidacy Form Reference Name* Adrian College Student Name * Knowledge of Applicant Approximately how long have you known the applicant? (years and months)* In what capacity do you know the student* Employee Student Volunteer Acquaintance Other Applicant's Promise as a BSW Student Please rank the following characteristics based on a 10 point scale Exceptional (10-9), Above Average (8-7), Average (6-5), Below Average (4-3), Poor (2-1), or No Basis for Ranking (NB) Writing Ability* NB 1 2 3 4 5 6 7 8 9 10 Interaction with Work Groups* NB 1 2 3 4 5 6 7 8 9 10 Knowledge of Agency/ System & Services Offered* NB 1 2 3 4 5 6 7 8 9 10 Interaction with Public/Clients* NB 1 2 3 4 5 6 7 8 9 10 Openness to Supervision* NB 1 2 3 4 5 6 7 8 9 10 Openness to Diversity* NB 1 2 3 4 5 6 7 8 9 10 Attitude* NB 1 2 3 4 5 6 7 8 9 10 Motivation* NB 1 2 3 4 5 6 7 8 9 10 Intellectual Ability* NB 1 2 3 4 5 6 7 8 9 10 Autonomy* NB 1 2 3 4 5 6 7 8 9 10 Promptness* NB 1 2 3 4 5 6 7 8 9 10 Oral Expression* NB 1 2 3 4 5 6 7 8 9 10 Emotional Maturity* NB 1 2 3 4 5 6 7 8 9 10 Reliability* NB 1 2 3 4 5 6 7 8 9 10 Personal Appearance* NB 1 2 3 4 5 6 7 8 9 10 Observation About Applicant How do you view this student's strengths and needs?* What is your assessment about this student’s openness to new ideas and willingness to stand up for what s/he believes? How good is this student’s fit?* Evaluation Summary This student's performance in my contact and experiences with her/him* Went beyond expectations Met expectations Sometimes met expectations Fail to meet minimal expectations Recommendation to BSW Program* Highly recommend Recommend Recommend with reservation Do not recommend Signature * Date* First Name* Last Name* Title* Organization* Your Address* City/State/Zip Code of Current Address* Telephone