Nursing Scholarship Faculty Reference Form
Greetings,
____________________________ is applying for one of the nursing scholarships offered through
Minnesota State University at Mankato. As part of the application process, applicants must obtain
one reference from a school of nursing faculty member. Please complete this evaluation form and
return to Cindy Larson in the School of Nursing Office or email to her at cynthia.larson@mnsu.edu by
February 14th, 2014.
Thank you for your assistance in selecting the best candidate.
Check those which apply:
Exceeds
Expectations
Meets
Expectations
Does Not
Meet
Expectations
No
Opportunity
to Evaluate
Professional Nursing Commitment
Clinical Reasoning/Critical Thinking
Organizational Ability
Integrity
Exhibits Nursing Values such as
caring, compassion & empathy
Interpersonal & Communication
Skills
Self-motivated & Self-Directed
Attendance & Punctuality
Leadership Abilities
Clinical Performance
Teamwork
Please comment on the student’s talents and strengths:
Please comment on the student’s weaknesses and area for improvement:
Overall Evaluation:
Strongly Recommend__________Recommend_________Do Not Recommend_________
Faculty Signature____________________________________ Date__________________