Academic Reference Questionnaire - ApplyWeb

[Pages:2]Academic Reference Questionnaire

Print your name and address in the space below. Check (in the appropriate box) whether you have or have not waived the right to review the information contained in your admissions file and give this form to your academic reference. Relatives are not permitted to complete reference questionnaires.

Applicant's Last Name

First Name

( )

-

M.I.

Home Telephone Number

To Be Completed by the Applicant

Mailing Address

City

State

Zip Code

E-mail address

I have / have not waived the right to review my admissions file.

If you are a non-traditional student (23 or older), please use this form as an Employer Reference, to be completed by your supervisor at work. The Employer Reference you choose ONLY needs to fill out the back side of this form, not the information below!*

To Be Completed by the Academic Reference

*If you are an Employer Reference, please skip to the next section. Each applicant for admission to Cincinnati Bible College must submit an academic reference questionnaire. We value your comments and request that you give a full and candid report, so that fair consideration may be given to the applicant.

1. How long have you know the applicant?

2. In what academic setting have you known the applicant?

3. How well do you know the applicant? (Check where appropriate)

By name/sight

Very well/numerous personal contacts

Casually/few personal contacts Know the student quite well

4. Are the parents of this applicant: Supportive of academics Unsupportive of academics

5. Briefly describe why you believe this student will succeed in completing a college degree.

6. How would you describe the applicant's approach to his/her academics?

7. Describe the applicant's strengths and weaknesses.

8. How would you describe the writing skills of the applicant:

stream of consciousness

well-constructed, supported, organized

thoughtful, but lacks organization

Other comments:

To Be Completed By the Employer Reference

*Please Skip to the next section if you are an Academic Reference. 1. How long has the applicant been employed in their present position? 2. Is the applicant punctual? 3. Does the applicant work within the guidelines of the company? 4. Please describe the applicant's attitude toward their work. 5. Please describe the applicant's outstanding abilities or talents.

6. How well does the applicant follow instructions?

7. Would you describe the applicant as a self-starter or one who needs to be motivated by others?

Thank-you To be Completed by Academic/Employer Reference

*Must be completed by Academic or Employer Reference. Would you recommend that we accept this applicant? Yes No Don't Know

Name (Please print)

( ) -

( ) -

Home Telephone Number Work Telephone Number

Relationship to Applicant E-mail

Street Address

City

State

Zip Code

Signature

Date

Thank you for taking the time to complete this questionnaire. Your observations will assist us in our evaluation of the applicant. Please return this questionnaire at your earliest convenience to:

Cincinnati Bible College Attn: Admissions 2700 Glenway Avenue Cincinnati, OH 45204

Or, fax to:

513 - 244 - 8453 Attn: College Admissions

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