The Honors
Program
Columbus State University
Admissions Criteria & Application
2012-2013
The Honors Program is designed for academically talented students committed to engaging in their
discipline through experiential learning and creative scholarship. The program strives to bring together
academically talented students from diverse backgrounds and interests. Applications should reflect not only
the applicant’s superior academic records, but also his or her commitment to learning for learning’s sake,
interest in engaging in their discipline, and willingness to explore other disciplines, cultures, and societies.
The minimum requirements for students seeking admission to the CSU honors program as undergraduates
are:
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Completion a minimum of 15 semester hours;
An overall cumulative grade point average of 3.4 or higher in academic courses that fulfill major
requirements.
To apply for admission students should complete this form and obtain a letter of recommendation from a
professor, preferably in your discipline. Applications and letters of recommendation may be submitted to
the address below or may be emailed. If items are sent via CSU email accounts, they will be considered
“signed” electronically.
Dr. Cindy S. Ticknor
Honors Program Director
4225 University Avenue
Columbus State University
ticknor_cindy@columbusstate.edu
Name:
Email:
Phone:
Alternate Email:
CSU ID:
Major:
By signing below, I permit the honors program director or designated representatives access my academic
records to determine my qualifications for the honors program. If admitted to the CSU Honors Program, I
agree to enroll in a minimum of one honors course following notification of my admission to the program
and will adequate annual progress to completing the honors program as described in the Honors Program
Handbook available at http://honors.columbusstate.edu.
Date
____________________________________________
Signature
Revised 10/12
Describe briefly why you are interested in joining the honors program at Columbus State University?
Our honors program thrives on rich interactions of its diverse members, who are leaders, artists, scientist and more.
What is one attribute that you will contribute to our membership?
How did you hear about the program?
Advisor
Student
Instructor/Faculty
Website
Email
Other:
Revised 10/12
CSU Honors Program
Recommendation Request Form
Application may be downloaded as a word document at http://www.columbusstate.edu/honors/
Form may be returned by mail, fax or email to:
Honors Program
4225 University Avenue
Columbus GA 31907
Ph: 706-507-8771 Fax: 706-507-8775
ticknor_cindy@columbusstate.edu
To be filled out by the applicant:
Name _____________________________________________________________ (Please print or type)
Federal law grants access to educational records to students after enrollment. I voluntarily waive my right
of access to the information contained in this recommendation and agree that it shall remain confidential.
Applicant's Signature ___________________________________________________ Date ___________
To the recommender:
Name________________________________________________________________________________
(Please print or type)
Title and affiliation _____________________________________________________________________
Address _____________________________________________________________________________
_____________________________________________________________________________
Phone (_________) _________ - ____________
The Honors Program Committee of Columbus State University appreciates your assistance in evaluating
this applicant. Please complete both pages of this form and return it to the address above. Responses
should involve specific knowledge relevant to the applicant's abilities to excel in college-level academic
work and to participate in a program of advanced study. The applicant has chosen you to provide an
honest, candid assessment of his/her abilities. Your recommendation will be considered in the admissions
process. Federal law grants access to educational records to students after enrollment. Therefore, unless
the statement which waives access (above) is signed by the applicant, we cannot guarantee the
confidentiality of your recommendation.
How well do you know the applicant?
 Very well
 Moderately
 Slightly
How long have you known the applicant? _______________________________________________
My relationship to the applicant was (or is) in the following capacity:
 College instructor or professor
 High School Teacher
 Other (please specify)______________________________________________________________
Revised 10/12
Applicant Name: ___________________________________________________________________
How do you rate the applicant on each of the following characteristics? Please place an "X" in the rating
box which best describes the applicant.
Outstanding Good
Characteristics
Intellectual ability (keenness, originality, capacity)
Industry (promptness, perseverance, dependability)
Initiative (imagination, independence, resourcefulness)
Academic competency
Character (integrity, honesty, responsibility, ethics)
Maturity (assertiveness, leadership)
Personality (self-confidence, sense of humor)
Ability to work with others
Tolerance of alternate opinions and beliefs
Expression (oral)
Expression (written)
Personal appearance (neatness, cleanliness, grooming)
Attitude towards difficult challenges
Fair
Poor
No basis
for judgment
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Please express your opinions based on your contact with the applicant. You may share any information
which would be relevant to his/her character, capabilities, and performance. Your time and effort in this
endeavor are of great value to the Honors Program Committee in its consideration of this applicant.
(Please print or type.)
Please provide your overall recommendation of the candidate with respect to their admission to the
Honors Program (please check one):
 I highly recommend this applicant
 I recommend this applicant but with some reservations
 I recommend this applicant
 I am not able to recommend this applicant
Signature of recommender ______________________________________ Date ___________________
Revised 10/12