DEPARTMENT OF
REFERENCE FORM IN SUPPORT OF ADMISSION
CHEMICAL & BIOMEDICAL
TO MASTERS & PHD PROGRAMS OF STUDY
ENGINEERING, UNIVERSITY OF SOUTH FLORIDA
APPLICANT INFORMATION
Name:
Email:
Phone #:
Address :
USF U ID:
In accordance with the Family Education Rights and Privacy Act of 1974, applicants may waive the right to see
letters of recommendation. Please indicate your choice with your signature.
I waive my right to see this recommendation
I retain my right to see this recommendation
___________________________________________
Signature
_______________________
Date
EVALUATOR
The above applicant has applied to our graduate program of study. To assist us in our admission process, we
are requesting an evaluation of the applicant.
In what capacity and how long have you known the applicant
Please evaluate the applicant in the following categories on the scale provided below.
Comparison group used (undergraduates, graduates, …):
Top 10%
Top 25%
Top 50%
Bottom 50%
Knowledge in field of study
Motivation and Maturity
Independence
Creativity
Dependability and Integrity
Resourcefulness
Verbal skills
Writing Skills
Teaching Ability
Overall Intellectual Ability
PLEASE COMPLETE OTHER SIDE
DEPARTMENT OF CHEMICAL & BIOMEDICAL ENGINEERING
COLLEGE OF ENGINEERING
University of South Florida ▪ 4202 East Fowler Ave., ENB 118 ▪ Tampa, FL 33620-5350
(813) 974-3997 ▪ FAX (813) 974-3651
No Basis
DEPARTMENT OF
REFERENCE FORM IN SUPPORT OF ADMISSION
CHEMICAL & BIOMEDICAL
TO MASTERS & PHD PROGRAMS OF STUDY
ENGINEERING, UNIVERSITY OF SOUTH FLORIDA
In the space below (or a separate sheet), please provide a written assessment of the applicant’s potential for
graduate study. Please specifically comment on weaknesses and strengths that you think are relevant.
EVALUATOR INFORMATION
Name:
Email:
Phone:
Title:
Affilitation:
___________________________________________
Signature
_______________________
Date
DEPARTMENT OF CHEMICAL & BIOMEDICAL ENGINEERING
COLLEGE OF ENGINEERING
University of South Florida ▪ 4202 East Fowler Ave., ENB 118 ▪ Tampa, FL 33620-5350
(813) 974-3997 ▪ FAX (813) 974-3651