Recommender's Name
*
First Name
Last Name
Phone
*
(###)
###
####
Framework Fellows Applicant's Name
*
First Name
Last Name
How long have you known the applicant?
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Less than 1 year
Between 1-2 years
Between 3-4 years
Between 5-10 years
Over 10 years
How well do you know the applicant?
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Very well
Fairly well
Not very well
In what capacity have you known the applicant?
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Cooperation: check all that apply
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Works well with others
Intimidated in group settings
Shares responsibility
Dominates in group settings
Does not work well with others
No basis for judgment
Responsibility: check all that apply
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Dependable
Irresponsible, careless
Avoids responsibility
Completes work in a timely manner
No basis for judgment
Sensitivity to Others: check all that apply
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Responsive to the needs of others
Insensitive to the feelings of others
Compassionate, caring
Impatient with others
Intolerant to opposition
No basis for judgment
Character: check all that apply
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Teachable
Undeveloped in important areas
A person of integrity
Questionable character
Trustworthy
No basis for judgement
Emotional Maturity: check all that apply
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Accurate self-appraisal
Insecure, poor self-image
Prone to anger
Prone to depression
Exercises self-control
Demonstrates emotional stability
Emotionally unstable
Insecure
No basis for judgment
Relational Maturity: check all that apply
*
Approachable, sought by others
Avoided by others
Tolerated by others
Self-absorbed
Aware of the needs of others
Difficulty in maintaining relationships
Socially developed/mature
No basis for judgment
Leadership: check all that apply
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Demonstrates clear leadership abilities
Potential for leadership
Authoritarian, can be domineering
Respected leader
Can make difficult decisions
Avoids leadership responsibility
No basis for judgment
Communication: check all that apply
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Articulate, effective communicator
Difficulty expressing ideas
Argumentative
Good listener
Respectful and tactful
No basis for judgment
Decision Making: check all that apply
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Insightful, well-thoughtout
Impetuous, acts without thinking
Seeks the counsel of others
Disregards sound advice
Displays wisdom
No basis for judgment
Motivation: check all that apply
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Highly motivated in their work
Easily distracted/discouraged
Demonstrates persistence
Lacks resolve/determination
Easily swayed by circumstances
Focused
No basis for judgment
Do you have any reservations with regard to the applicant's decisions to pursue the Framework Fellows Program at this time in his/her life? If yes, please comment in the following section.
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Yes
No
Please comment on your perception of the applicant's strengths and weaknesses, as well as his/her readiness to begin the Fellows program.
If there is additional information which you think will assist us in the evaluation process, please provide such information below. This may also include the names and emails of additional references who would be qualified and willing to comment on the applicant’s readiness for the Fellows program.
In considering the applicant’s suitability for this program please check one of the following:
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Not recommended
Recommended with reservation
Recommended with confidence
Recommended with enthusiasm