I understand that your candid evaluation, together with official school records and autobiographical information that I will supply as needed, will be collected by the Biology Chief Health Professions Advisor to make a packet of evaluation letters that will be copied and sent to the school(s) to which I apply. I will supply to the Advisor a list of the admissions officers, addresses and phone numbers of all schools to which I am applying.

Signature of student requesting evaluation: __________________________________

Date of signature: ________________

______ I do not waive my rights.

______ I do waive all rights which I otherwise would be able to assert under the Family Educational Rights and Privacy Act of 1974 with respect to this evaluation. By such waiver, I expressly consent to, and do hereby authorize, Southern Illinois University at Edwardsville and any professional school to which Southern Illinois University at Edwardsville may hereafter forward this evaluation or its contents, to retain said evaluation of information in a strictly confidential manner, specifically to include withholding such from me and my family whenever I may request to see it or to be informed of its contents, and otherwise to deny me access to this evaluation once submitted by the evaluator.

Signature of student requesting evaluation: ________________________________

Date of signature: _______________

To the evaluator:

Please attach your evaluation letter to this form.

In your letter, please indicate the nature and frequency of your contact with the student and the confidence with which you would recommend the student for admission to the professional school indicated.

Professional schools are interested both in the student's academic abilities and intellectual potential and in personal qualities that may be related to his or her performance as a health professional. Wherever possible, give specific examples of qualities you discuss. Please comment on some or all of the following qualities:

• intellectual ability (depth of knowledge, judgment, logical thought, common sense, integration)
• scientific aptitude (resourcefulness, independence, decisiveness, intellectual curiosity, motivation)
• diligence (industry, perseverance, genuine interst, dedication, conscientiousness)
• ability to communicate (written and oral)
• integrity
• cooperation (respect for authority, ability to work with others, tolerance)
• personality (disposition, tact, courtesy, affability, poise)
• sensitivity (compassion, empathy, consideration)
• emotional stability (self control, maturity, composure, receptiveness to criticism)