Illinois State University
Department of Psychology
Applicant Recommendation
Master’s Degree Program in Psychology
Application Deadline: January 15
This form is an interactive Word document that should be completed on a computer. The applicant should
complete Section I below, saved the form as a Word document, and then send it as an e-mail attachment to
the individual providing the recommendation. The recommender should complete Section II below. The
completed Applicant Recommendation must be signed and/or dated by the recommender. A separate letter
of recommendation may also be provided with the completed Applicant Recommendation. The letter should
be provided on school or business letterhead.
When completing the University’s application, the applicant must identify three recommenders and provide
a valid e-mail address for each individual. Illinois State will notify the recommender by e-mail with
instructions that include a user name and password for uploading the completed Applicant Recommendation
(and letter of recommendation, if applicable) in the appropriate master’s application.
SECTION I – The applicant should complete this portion of the Recommendation.
Name:
E-mail address:
Name of the individual completing this recommendation:
Application for Master’s Degree Program with a graduate sequence in (select one):
Cognitive and Behavioral Sciences
Developmental Psychology
Industrial/Organizational-Social Psychology
Quantitative Psychology
The Family Educational Rights and Privacy Act of 1974, Public Law 93-380, gives you a right of access to this
form and any letter of recommendation. You can also waive your right of access to this information. Whether
you choose to retain or waive your right of access to this recommendation, your decision will not affect the
Graduate Admissions Committee’s review of this recommendation. Retain or waive your right of access to
this recommendation by checking one the statements below.
I waive my right of access to this Recommendation.
I do not waive my right of access to this Recommendation.
Applicant’s Signature
Date
Check this box and include the date (
) in lieu of your signature, if this form is submitted to the
individual providing your recommendation as an e-mail attachment.
SECTION II – The recommender should complete this portion of the Recommendation.
How well do you know the applicant?
What course(s) did the applicant complete with you?
What other contact have you had with the applicant?
Evaluate the applicant in the categories below based on your experiences with other college students.
Upper
5%
Upper
10%
Upper
20%
Average
Below
Average
NA or
Unknown
Academic potential
Intellectual independence
Capacity for analytical thinking
Ability to work with others
Drive and motivation
Potential as a research assistant
Potential as a teaching assistant
Social skills (interpersonal/sensitivity)
Evaluate the applicant’s personal characteristics as they may relate to assuming professional responsibilities.
Are there any other factors that should be considered about this applicant?
Check the appropriate statement below.
I expect the applicant to become an outstanding graduate student.
I expect the applicant will be above average as a graduate student.
I expect the applicant to perform as an average graduate student.
I expect the applicant to perform below average as a graduate student.
Name:
Position or Title:
School, Agency, Company:
Address:
City, State, Zip Code:
Signature
Date
Check this box and include the date (
) in lieu of your signature. The Applicant Recommendation
(and letter of recommendation, if applicable) must be submitted online in the master’s application by the
January 15 deadline.