recommendation form - polyu · 812 . this recommendation form is divided into 2 parts: applicants...
TRANSCRIPT
2018-19 Version
RECOMMENDATION FORM
MASTER OF NURSING (PROGRAMME CODE 53081)
Part A (To be completed by applicant)
Applicant
Name:_________________________________________________________(_______________) Surname First Name Chinese Name if any
Application No.:
Recommender
Name:_________________________________________________________(_______________) Surname First Name Chinese Name if any
Work organization:_______________________________________________________________
Position held:____________________________________________________________________
Address:________________________________________________________________________
Telephone number_______________________ Email address:____________________________
Type of reference: □ Academic □ Employer
Form AR812
This recommendation form is divided into 2 parts:
Applicants are required to complete Part A and then invite two recommenders to complete Part B.
Recommenders are invited to return the completed and signed recommendation form to Academic Registry by email: [email protected] or by post to The Academic
Registry Service Centre, Room M101, Li Ka Shing Tower, The Hong Kong
Polytechnic University, Hung Hom, Kowloon. Please also quote the applicant's application no. with programme code (53081) in the email or on the envelope.
All personal data of unsuccessful applicants will be destroyed.
(i)
(iii)
(ii)
2018-19 Version
Part B (To be completed by recommender)
RECOMMENDER The person whose name appears above has applied for admission to the Master of Nursing (Pre-registration)
programme of School of Nursing, The Hong Kong Polytechnic University. It would be helpful to the Admission
Committee if you could provide your assessment of the applicant. Please complete the information requested of this
form.
1. Please describe your relationship with the applicant and how long you have known him/her.
____________________________________________________________________________________________
2. What do you consider to be the applicant’s strengths?
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
3. What do you consider to be the applicant’s weakness?
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
4. Please tick and rate the applicant using the following scales:
Outstanding
Top 5%
Above
average
Top 25%
Top 50% Below
average
No
opportunity
to observe
Motivation
Leadership capabilities
Integrity
Judgement & maturity
Ability to work with others
Intellectual capacities
Quality of written/oral English
Analytical ability
5. Please tick in the appropriate box:
□ Highly recommended □ Recommended □ Not recommended
Thank you for your evaluation.
Signature_________________________________ Date_________________________________
Form AR812