Graduate Certificate Reference Form

Name of Applicant*

First Last

Reference Name*

First Last

Reference Title*

Reference Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Reference Email*

Reference Phone*

The applicant whose name appears above is applying for admission to a year-long Graduate Level Certificate Program at Hebrew College. Your candid estimate of this applicant’s intellectual performance, promise, personal qualities, and Jewish commitment will help our committee to make final decisions for admission.

Under the Family Education Rights and Privacy Act of 1974 (Buckley Amendment), which gives students the right to inspect and review their educational records, students may waive their right to see specific confidential statements and letters of evaluation. If you would like to know whether the above applicant has waived this right, please contact Debrah Ron, dron@hebrewcollege.edu.

How long and in what capacity have you known the applicant?*

In the categories below, please rate the applicant using numbers 1 through 5. If necessary, please explain these ratings as part of your discussion in answering the essay below.

1 – cannot assess (if you have not had direct contact with the applicant in that category.)
2 – below average
3 – average
4 – above average
5 – superior

Please indicate your overall recommendation

Strongly recommend
Recommend
Recommend with minor reservation
Recommend with substantial reservation
Do not recommend candidate for admission
Do not feel qualified to make a recommendation

Statement*

Please evaluate the applicant’s capacity for success in a year-long graduate level field of study, commenting, when possible, on the candidate’s academic potential and ability, character and interests, and areas in which this candidate needs to work on improvement and change. Please note that a description of strengths and weaknesses will be more helpful to the Admissions Committee than a uniformly positive statement.

Electronic Signature of Reference*

Date*