REFERENCE LETTER FOR INDIVIDUALS APPLYING FOR ADMISSION
Please complete the form below and answer questions pertaining to the applicant to the best of your knowledge
Name of Applicant (Applying to the Program):
First Name
Last Name
Program Applying For
*
Diagnostic Medical Sonography (Ultrasound)
Radiography (X-Ray)
Radiation Therapy
Medical Dosimetry
EMT-Basic
Paramedic
Surgical Technology
Practical Nursing
How long have you known the applicant?
In what capacity do you know the applicant (please note that the reference letter may not come from a family member or friend, unless there is a professional affiliation)?
What do you feel are the applicants key 1) strengths and 2) weaknesses?
Kindly provide a your overall impression on the applicant's character and ability to thrive in the healthcare field.
REFEREE'S CONTACT INFORMATION
Today's Date
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Your Name
*
First Name
Last Name
Your E-mail Address
*
example@example.com
Place of Employment
This is a fill in the
blanks
field. Please add appropriate
blank
fields and text.
Primary Phone Number
*
-
Area Code
Phone Number
I attest that the above information is accurate and written to the best of my knowledge about the individual applying to the Program. I understand that Center for Allied Health Education (CAHE) does occasionally verify reference letters.
*
YES
Signature
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