DEAN OF ADMISSIONS Biota College 13800 BIOLA AVENUE LA MIRADA, CALIFORNIA 90639
REFERENCE
SCHOOL O EMPLOYER 0 (CHECK APPROPRIATE SQUARE)
Name of Applicant ----------------------- ------------------ LAST NAME FIRST NAME MIDDLE NAME
Applicant's Address_________________________________________ STREET CITY STATE ZIP TO THE APPLICANT: Print your name and address on the lines above and give to your high school counselor, principal, or some other school administrator who is qualified to give a reference for you. Transfers should submit form to a teacher or administrator in the college who knows the applicant. Those who have been out of school for at least one year and have been working should submit this form to their employer. Applicant should provide a stamped envelope addressed to the Dean of Admissions for the person filing the reference. I willingly waive my right of access to see this recommendation knowing that this waiver is NOT required as a condition for admission.
Signature I. GENERAL EVALUATION In some cases write in brief comments, in others, encircle the best response.
1. How long have you known the applicant?______________________________ In what relationship? _______________________________________
2. How well do you know the applicant? casually 3. What is your opinion regarding the aptitude of the applicant for further academic work? Negative hesitant moderate strong highly enthusiastic Very well well
no knowledge
4. Your opinion of the applicant's level of social readiness for college: Negative hesitant moderate strong no knowledge 5. Has the applicant ever used illegal drugs? ------------------------------ 6. What goals does the applicant have? 7. Applicant's relationships with peer group: Applicant is: Sought out admired but not sought out tolerated avoided rejected 8. State your opinion of the student's integrity: _____________________________ highly enthusiastic
9. How successful has the applicant been in school or work? _________________________
10. Describe briefly the applicant's health and physical vitality: _______________________
11. What are the applicant's strong points (include special abilities)? ______________________
12. What are the applicant's weaknesses or personality defects? _______________________
13. What is the applicant's attitude toward authority and his responsiveness toward instruction? ___________
14. General comments: _________________________________________
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