Form D
Wichita State University
W. Frank Barton School of Business
To the applicant:
Please fill out the section below and forward this form to an individual who has professional knowledge of you.
You should enclose, for the person writing the recommendation, a stamped envelope addressed to:
Graduate Studies in Business (EMBA)
201 Clinton Hall
Wichita State University
1845 Fairmount St.
Wichita, Kansas 67260-0048
Liz.McLain@wichita.edu
Name of candidate:
Name of evaluator:
Date:
To the evaluator:
The person above is applying for admission to the Executive MBA Program at Wichita State University.
Please answer the questions below in as specific and candid a manner as possible, particularly noting maturity, purposefulness,
initiative and potential. The information requested below will be used for the sole purpose of the graduate admission decision and will
be held in confidence. This form is provided for your convenience. If you prefer to substitute a letter of recommendation, please do so.
We are aware that we are asking for time and effort on your part in providing this information; however, your appraisal is very helpful
to us and your effort is greatly appreciated.
1. When, for how long and in what capacity have you known the applicant?
2. What are the qualifications that most influence your opinion of the applicant?
3. What are the applicant’s outstanding talents and capabilities? Areas for improvement?
4. How does this applicant compare to others you have observed as candidates for graduate education?
Superior
Above average
Averag
e
Below
average
Not known
Academic Promise
Independent Thought
Acceptance of Responsibility
Task Completion
Creativity
Sound Judgment
Analytical Ability
Interpersonal Skills
Leadership Ability
Written Communication
Oral Communication
Personal Motivation
Record of Achievement
Career Potential
Community Involvement
Integrity
Teamwork
Quick Learning
5.
How do you see the Executive MBA Program contributing to the applicant’s personal growth and potential for
achievement in his/her organization and/or community?
Company
name:
Signature:
Name:
Address:
City:
Date:
Title:
Phone:
State:
ZIP:
Wichita State University does not discriminate in its programs and activities on the basis of race, religion,
color, national origin, gender, age, sexual orientation, marital status, political affiliation, status as a
veteran, genetic information or disability. The following person has been designated to handle inquiries
regarding nondiscrimination policies: Director, Office of Equal Employment Opportunity, Wichita State
University, 1845 Fairmount, Wichita KS 67260-0205; telephone (316) 978-6791.