Academic Reference

Admissions

Harding Confidential Academic Reference

To be filled out by a counselor, principal or teacher (dean of students or registrar if applying as a transfer student).

This reference form will be directly submitted to the Director of Admissions Services of Harding University. Your response will remain confidential.

To use a printable version that must be mailed in, click here.

Applicant's Information

Applicant Name:
Applicant Address:
Applicant City:
	Applicant ZIP:

Reference Information Please choose one on each line:

Yes No Unknown	1. Is there any question about the student's ability to succeed academically?
Yes No Unknown	2. Is the applicant now, or has he/she ever been, on academic probation?
Yes No Unknown	3. Has he/she been dismissed or suspended from school/college for any reason?
Yes No Unknown	4. Has the applicant ever required disciplinary action by school/college officials?

Please explain any "Yes" answers to the previous questions.	Also, add other comments concerning leadership abilities, personality, special talents, problems, etc. In compliance with Section 504 of the Rehabilitation Act of 1973, you are advised to avoid reference to any handicaps an applicant may have.

Please choose one of the following: Recommended for Admission
Not Recommended
Prefer not to make a recommendation
Phone me

Please choose one of the following: I am well acquainted with the applicant. I am moderately acquainted with the applicant.
I do not know the applicant.

Your Information

Name:
Occupation/Title:
Address:
City:
	ZIP:
Phone:
E-mail:

Info for
Freshmen
Transfer
Graduate
International
Parents
Adult Education
Online Classes

Contact info
501-279-4407
Address:
Harding University
915 E. Market Ave.
Searcy, AR 72143