Recommendation Form for the Middle Georgia State University Bachelor of Science in Social Work (BSW) Program
Thank you for taking the time to provide a recommendation for the student you will list. Your honest and reflective feedback will help us evaluate this applicant for the BSW program.

Please note that professional recommendations may not come from personal friends, relatives, or social acquaintances.

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Applicant's Last Name *
Applicant's First Name *
Name of person completing this form *
Type of Reference *
Organization/Institution of person completing this form *
Title/Position/Credentials of person completing this form *
Phone number of person completing this form *
How long have you known the applicant (years/months)? *
How thoroughly do you  know the applicant? *
What is or was your relationship to the applicant? *
If other listed, please describe your relationship to the applicant. *
Assessment of Applicant's Disposition
Please rate the following behaviors and qualities of the applicant to the best of your knowledge and judgment.
*
Exceptional
Above Average
Average
Below Average
Poor
Unknown
Honesty
Compassion for others
Emotional maturity
Ability to withhold judgment or bias
Sensitivity to others
Respect for others
Motivation to work and/or learn
Intellectual abilities
Initiative
Ability to follow-directions
Ability to seek/use supervision when needed
Oral communication skils
Written communication skilss
Please share any information, known to you, related to character and temperament that would have an impact on the applicant’s ability to be an effective social worker? Please include positive or negative comments. *
Though not required, if you would like to submit a  letter of recommendation please email this to rebekah.hazlettknuds@mga.edu
Level of recommendation *
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