Reference - Academic
Advisor
Applicant:pleasecompletethissection.
Applicant'sName
IncompliancewiththeFamilyEducationRightsandPrivacyActof1974,thecandidatemayhaveaccess
tothisevaluationunlessaccessiswaivedbycompletingthefollowingstatement:
I,______________________________________,waivemyrighttoaccessthisevaluation.
Signature_____________________________________ Date_________________ TotheAcademicAdvisor:
TheNationalStudentExchange(NSE)providesstudentswiththeopportunitytoattendanothermember
universitywithintheUnitedStates,Canada,Guam,PuertoRicoandtheU.S.VirginIslandsforasingle
termoranacademicyear.StudentsparticipateinNSEtotakeadvantageoftheuniquegeographic,
cultural,andacademiccharacteristicsofinstitutionsand/orregions.
Inmakingdecisionsontheappropriatenessofastudent'sparticipationintheexchange,weneedto
knowabouttheirmotivation,adaptability,academicskills,andthosepersonalqualitiesthatwillgive
studentstheabilitytobenefitfullyfromtheexchangeexperience.Whilewewillappreciateany
observationsthatwillassistusinevaluatingthepresentapplicant,ofspecialinterestarequalitiessuch
ascompetence,independence,assertiveness,resourcefulness,qualityofperformance,confidence,
socialskills,open-mindedness,andintegrity.
Pleaseindicatethebasisandextentofyouracquaintancewiththeapplicant.Placingyourremarksina
comparativeperspectivewillfurtherassisttheNSEofficeinreachingadecisionabouttheapplicant.
Insummation,pleasestatefranklyyouropinionofthisapplicant'schancesforacademicandnonacademicsuccessinanexchangeprogram,weighingbothstrongandweakpoints.
Occasionally,anacademicadvisorhasnothadenoughcontactwithastudenttodoanadequate
personalevaluation.However,inthatsituationwewouldlikeastatementregardingyourwillingnessto
workwiththestudenttodeterminewherecoursestakenatthehostcampuswillfitintothestudent's
homeacademicprogram.Wewouldalsoliketoknowtheappropriatenessofexchangeatthistimein
thestudent'sprogramofstudy.Weareparticularlyconcernedthatthestudent’sacademicprogresswill
notbehinderedbyparticipatinginNSE.Thosestatementscanbeenteredinsection4onthereverse
sideofthisform.
1. Howwelldoyouknowtheapplicant?(Checkthemostappropriateresponse.)
qExtensivecontactinavarietyofsettings
qWellacquaintedinclassroomorcampusenvironment
qLimitedcontactinclassroomorcampusenvironment
qOther______________________________________________________________________
2. Incomparisonwithotherstudentswhomyouhaveknownatcomparablestagesoftheireducation,
pleaseratetheapplicantintheseareas.(Circlethemostappropriateresponse.)
ExcellentVeryGoodAverage
Below Unableto
AverageJudge
AcademicAbility Maturity CooperationandAdaptability
InitiativeandMotivation SocialSkills Open-mindedness Integrity Independence Resourcefulness Self-Confidence 4
4
4
4
4
4
4
4
4
4
3
3
3
3
3
3
3
3
3
3
2
2
2
2
2
2
2
2
2
2
1
1
1
1
1
1
1
1
1
1
X
X
X
X
X
X
X
X
X
X
3. Exchangetoanothercampuswouldbeappropriatefortheapplicant:___Yes___No
4. Remarks
Basedonyourknowledgeoftheapplicant,pleasecommentonhis/herchancesforsuccessandwhat
wouldbegainedfromanexchangeexperience.
Name(print)___________________________________ Title
Phone ________________________ e-mail _____________________________________
Signature __________________________________ Returnthisformto:
UniversityofMontana
NationalStudentExchangeProgram
EmilyFerguson-Steger
101LommassonCenter
Missoula,MT59801
emily.steger@mso.umt.edu
Date
_____________________________________
_____________________