CLINICAL PSYCHOLOGY APPLICATION FOR ADMISSION



Professional Recommendation

Application for Admission – M.A. Clinical Mental Health Counseling, M.A. Marriage and Family Therapy

Part A – To be completed by Applicant

Have this form completed by an employer, professional acquaintance or faculty member of any discipline who knows you well. First, complete Part A and save the form under a new name. Then, email the form to your recommender who will complete Part B and have them email the form directly to: graduate.recommendations@wheaton.edu

I waive my right to access the requested recommendation

Date:       Applicant’s Signature or Typed Name:      

Part B – To be completed by Employer, Professional Acquaintance, or Faculty Member

The above student is applying for admission to Wheaton College Graduate School. A full and candid report is essential if fair consideration is to be given the applicant. This completed form is for the admissions process only and does not become a part of the student’s file.

1. How long have you known the applicant?

     

2. How well and under what circumstances have you known the applicant?

     

3. What was the nature and frequency of your contacts? (e.g. weekly supervisory sessions, occasional discussions)

     

4. In making the following ratings please keep in mind that they will be used to compare this student with other able students.

Truly Above Below Unable to

emotional/personality Traits Outstanding Average Average Average Judge

Capacity for objective evaluation of self

Maturity of judgment

Capacity for handling stress

Open-mindedness, tolerance of differences

Ability to handle anxiety and fears

Capacity for independence

Relates to others without being pushy or aggressive

Relates to others without manipulation

Forms relationships with ease

Capacity to receive feedback constructively

Overall maturity/emotional preparedness for graduate school

4a. Please comment on other noteworthy emotional traits:

     

Truly Above Below Unable to

5. Works Skills Outstanding Average Average Average Judge

Focus and consistency at work

Ability to work closely with others

Ability to work independently

Dependability

Openness to learning new skills

Willingness to take initiative

Appropriate professional attitude

6. Please comment on the intellectual and personal assets and liabilities which would influence the person’s training and practice in professional psychology.

     

Enthusiastically Strongly Recommended Not

7. SUMMARY Recommended Recommended Without Enthusiasm Recommended

RECOMMENDATION

|      |      |

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|Recommender’s Name |Email address |

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|      |      |

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|Business/Organization |Phone |

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|      |      |

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|Position |Date |

Please email this form to Graduate Admissions at Wheaton College using the following email address: graduate.recommendations@wheaton.edu

Or, fax the form to (630) 752-7047, or mail to Wheaton College Graduate Admissions, 501 College Ave., Wheaton, IL 60187. Thank you.

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