Confidential Reference Form

Please answer the following questions on behalf on the student applying to Harding University.

Please state candidly your opinion of this applicant’s suitability for admission to Harding in the context of our mission to provide a quality education that will lead to an understanding and philosophy of life consistent with Christian ideals.

This form is to be completed by a counselor, principal or teacher (professor or dean of students if applying as a transfer student) who is well acquainted with the student’s academic performance and ability and has had frequent interactions with the student and observed their conduct in a variety of situations.

First:
Middle:
Last:
City:

High School or College:


First:
Last:
Phone Number:
Email:
Relationship to Applicant
How well do you know the applicant?
I am well acquainted with the applicant. I am moderately acquainted with the applicant. I do not know the applicant. Other - Please Explain:
Explain:
To your knowledge, has the applicant ever been suspended or dismissed from school?
Yes No
To your knowledge, does the applicant have any personal habits or behavioral issues that, in your opinion, seem inconsistent with attendance at a Christian university?
Yes No
Academic Interest & Motivation	Poor Fair Good Very Good Excellent
Reliability	Poor Fair Good Very Good Excellent
Maturity	Poor Fair Good Very Good Excellent
Leadership	Poor Fair Good Very Good Excellent
Integrity	Poor Fair Good Very Good Excellent
Adaptability & Resourcefulness	Poor Fair Good Very Good Excellent
Ability to work with others	Poor Fair Good Very Good Excellent
Other comments you would like to share:
Please choose one of the following:
Recommended for Admission without reservation Recommended for Admission with reservation Not Recommended Prefer not to make a recommendation Please phone me

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