LSUS/LSUHSC-Shreveport MPH Applicant Recommendation Evaluator: The LSUS/LSUHSC-Shreveport MPH Program would like to thank you for taking time to complete your recommendation on this applicant. Question Title * 1. Please type the name of the applicant your are referring for the MPH Program: Question Title * 2. Type your First Name Question Title * 3. Type your Last Name Question Title * 4. Your Occupation: Question Title * 5. Your Organization: Question Title * 6. Your email: Question Title * 7. How long have you known the applicant? Question Title * 8. How Well do you know the applicant? Extremely Well Moderately Not Very well Question Title * 9. In what capacity do you know the applicant? Question Title * 10. Please rate the following characteristics for this applicant: Not Observed Below Average Average Above Average Excellent Adaptability Adaptability Not Observed Adaptability Below Average Adaptability Average Adaptability Above Average Adaptability Excellent Empathy Empathy Not Observed Empathy Below Average Empathy Average Empathy Above Average Empathy Excellent Ethics Ethics Not Observed Ethics Below Average Ethics Average Ethics Above Average Ethics Excellent Intellectual Ability Intellectual Ability Not Observed Intellectual Ability Below Average Intellectual Ability Average Intellectual Ability Above Average Intellectual Ability Excellent Interpersonal Relationships Interpersonal Relationships Not Observed Interpersonal Relationships Below Average Interpersonal Relationships Average Interpersonal Relationships Above Average Interpersonal Relationships Excellent Judgement Judgement Not Observed Judgement Below Average Judgement Average Judgement Above Average Judgement Excellent Leadership Leadership Not Observed Leadership Below Average Leadership Average Leadership Above Average Leadership Excellent Oral Communication - English Oral Communication - English Not Observed Oral Communication - English Below Average Oral Communication - English Average Oral Communication - English Above Average Oral Communication - English Excellent Professional Appearance Professional Appearance Not Observed Professional Appearance Below Average Professional Appearance Average Professional Appearance Above Average Professional Appearance Excellent Reliability Reliability Not Observed Reliability Below Average Reliability Average Reliability Above Average Reliability Excellent Written communication - English Written communication - English Not Observed Written communication - English Below Average Written communication - English Average Written communication - English Above Average Written communication - English Excellent Question Title * 11. What is your recommendation concerning the applicants admission to the program? Highly Recommend Recommend Recommend with Reservations Do Not Recommend Question Title * 12. Please use the space provided to supply any additional information on the applicant: Done