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REFERENCE FORM
Admission to the Master’s Degree Program
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NAME OF APPLICANT FOR WHOM YOU ARE PROVIDING A REFERENCE
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The person named above is applying for admission to the Master’s Degree Program at United Theological Seminary of the Twin Cities and has designated you as a reference. Your help in evaluating this person’s potential for theological study is of great importance to our admissions process. Thank you for your sincere and candid appraisal of this person’s character and ability.
Your answer
PERSONAL INFORMATION
Please provide your personal information below.
Name of Reference (You)
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Your answer
Position/Title
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Your answer
Address
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Your answer
Address 2
Your answer
City/State/Zip
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Your answer
Is the address above Work or Home?
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Work
Home
Other
Email
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Your answer
Preferred Phone
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Your answer
Phone Type
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Cell
Work
Home
Other
ROLE IN APPLICANT’S LIFE - Type of reference you are supplying?
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Professor (master’s program only)
Employer or Professional (master’s program only)
Spiritual Mentor (master’s degree or certificate)
Academic Mentor (master’s program or certificate)
Pastor (master’s program only)
Personal, non-relative (master’s program only)
How long, and in what capacities, have you known the applicant?
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Your answer
SKILL EVALUATION
Please evaluate the applicant in the following areas.
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Excellent
Above Average
Average
Below Average
No Basis for Judgment
Academic Ability
Academic Achievement
Verbal Skills
Written Skills
Relation to Others
Personal Maturity
Emotional Maturity
Excellent
Above Average
Average
Below Average
No Basis for Judgment
Academic Ability
Academic Achievement
Verbal Skills
Written Skills
Relation to Others
Personal Maturity
Emotional Maturity
APPLICANT’S POTENTIAL FOR LEADERSHIP
Please comment on the following areas. If you wish, you may submit a non-handwritten document giving the information below, instead of filling in the blanks provided.
1. Character: Ethical integrity, self-discipline and sense of responsibility.
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Your answer
2. Interests: Personal interests and/or social concerns of major interest.
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Your answer
3. Religious Interest: Your understanding of the applicant’s church involvement, spiritual journey and/or religious inquiry.
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Your answer
4. Strengths for Leadership: Characteristics that enhance the applicant’s vocational effectiveness.
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Your answer
5. Issues: Personal/relational issues you feel the applicant needs to address to be an effective religious leader.
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Your answer
6. General Assessment for potential religious leadership.
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Poor
Fair
Average
Good
Outstanding
OTHER COMMENTS
Is there anything else you think would be important for consideration of this candidate for admission?
Your answer
Thank you for your evaluation. Your comments will be carefully considered.
Reference Signature
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Your answer
Today’s Date
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