Health Education Reference Form for Graduate Assistantship.

 

Indicate the program to which the student is seeking admission:

MS in Education
Master in Public Health
PhD

 

Applicant Last Name:
Applicant First Name:
   
Person Completing this Form:  
Last Name:
First Name
Title
Institution/Agency
Email:
Note, after receiving your assessment, you will be sent a follow-up email to confirm your comments.
   

How long have you known the applicant?

 

In what capacity do you know the applicant?

To help us assess this candidate’s ability to serve as a teaching assistant, please answer the following
questions.


In what capacity have you observed this person’s teaching/presentations. If not, please explain how
you believe this candidate would be an effective teacher.

Discuss the candidate’s interpersonal skills and abilities to work with others.

Describe additional qualities that the candidate has that may make them more likely to succeed as a
teacher. Also, are there any concerns (major or minor) that may have an impact on the candidate’s
ability to teach:  (Please be specific and know that this may not disqualify a person from receiving an
assistantship).

OVERALL RECOMMENDATION:

I strongly recommend the applicant for a graduate assistantship.
I recommend the applicant with some reservation for a graduate assistantship.
I have substantial doubts about the applicant but think s/he should be given a chance to prove her/himself for a graduate assistantship.
I cannot recommend the applicant for for a graduate assistantship.

Any other comments: