The Ohio State University
Fisher College of Business
Select One
___________________________
Reference Form
To the Applicant
Each recommendation must include the completed Reference Form.
Applicant's Information
Name: ______________________________________________________________________________________________________________________________________________________________________
Last or Family Name/Surname
First
Middle
Date of birth
Select One
E-mail address: _________________________________________________________________________________ Major field of study: _____________________________________________________________________
List the name and address of the graduate program to which you are applying.
Admissions
The Ohio State University Fisher College of Business
Select One
(graduate program) _________________________________________________________________
110 Pfahl Hall
280 W. Woodruff Ave.
Columbus, OH 43210 USA
If you have had contact with a faculty member at Ohio State regarding graduate study, please indicate the following:
____________________________________________________________________________________
Faculty contact's name
____________________________________________________________________________________
Department
Recommender's Information
Name: ______________________________________________________________________________________________________________________________________________________________________
Title: ___________________________________________________________________________________ Institution: __________________________________________________________________________
Address: ____________________________________________________________________________________________________________________________________________________________________
Phone: _____________________________________________ FAX: _____________________________________________________ E-mail: _______________________________________________________
IMPORTANT: At least one direct contact number must be supplied, for verification purposes.
Applicant's Waiver of Right to Access
The Family Educational Rights and Privacy Act of 1974, as amended (P.L. 93-380), allows a candidate for admission, employment, or receipt of honors to waive his or her right of access to
confidential letters or statements written on his or her behalf if the recommendation is used solely for the purposes of admission, employment, or the receipt of honors and if the candidate,
upon request, is notified of the names of all persons making such recommendations on his or her behalf. The university does not require that you make such a waiver as a condition for
admission or award of fellowship or associateship. However, under the legislation you have the option of signing such a waiver as follows:
I hereby waive my right to access to this recommendation and any appropriate attachments which have been written by _____________________________________
(insert name of recommender) on behalf of my application to the Graduate School, The Ohio State University, and for award of a fellowship or associateship, if applicable. This
waiver is effective insofar as the recommendation is used solely for the purpose of admission or award of fellowship or associateship, if applicable.
Printed Name: ________________________________________________________ Date: ______________ Signature: __________________________________________________________________________
(continued)
The Ohio State University
Fisher College of Business
Select One
_____________________________
Reference Form (cont’d)
To the Recommender:
The applicant named below has applied for admission to the Fisher College of Business at The Ohio State University. Please complete this Reference Form.
______________________________________________________________________________________________________________________________________________________
Applicant’s Last or Family/Surname
First
Middle
1. Describe your relationship to the applicant, indicating how long you have known the applicant and in what capacity.
2. If you have worked with the applicant in a professional capacity, please describe your assessment of his/her abilities, skills, work habits, and professional development.
3. What would you say are the applicant’s major strengths?
4. What are the applicant’s major weaknesses? What areas do you think might be developed or improved?
5. How would you describe the applicant’s interpersonal skills (communications, leadership, teamwork, etc.)?
6. How would you assess the applicant’s qualifications, abilities and skills for completing graduate work in a business curriculum (e.g. motivation, analytical ability, creativity,
planning and goal setting, time management skills, etc.)?
Please rate the applicant on the following characteristics by checking the appropriate box:
Skills: Analytical / Quantitative
Skills: Problem Solving
Skills: Creativity
Exceptional
Good
Average
Poor
Unknown
Interpersonal: Oral Communication
Interpersonal: Written Communication
Interpersonal: Leadership
Interpersonal: Teamwork
Interpersonal: Motivation
✔
✔
Professional: Planning / Time Management
Professional: Supervising / Managing Others
Professional: Goal Orientation
If necessary, please provide additional information to explain your ratings or to add other comments.
(continued)
The Ohio State University
Fisher College of Business
Select One
_____________________________
Reference Form (cont’d)
Recommender (cont’d):
______________________________________________________________________________________________________________________________________________________
Applicant’s Last or Family/Surname
First
Middle
Select One
I would make the following recommendation for the applicant’s admission to the Fisher College ___________________________ program:
✔
Strongly recommend
Recommend
Recommend with reservations
Do not recommend
7. Additional comments:
Recommender, please read and sign below:
I have read the recommender information on the front of this Reference Form, including the direct contact number, and have made any necessary corrections. My preferred direct contact
number is:
Phone: _______________________________________ Fax: ______________________________________________ E-mail: ________________________________________________
Printed Name: ________________________________________________________________ Signature: _________________________________________________________________