EVALUATION FORM
UAB Graduate School
The University of Alabama at Birmingham
1400 University Boulevard, HUC 511
Birmingham, AL 35294-1150
 		Supporting Application
for Admission to the
UAB Graduate School
INSTRUCTIONS TO APPLICANTS
After filling out the identifying information in the spaces below, distribute the appropriate number of forms to instructors and others who are qualified to evaluate your qualification for graduate school Number of Forms Required:
Applicants to MBA and MAc programs: none
Applicants to all other programs: three
SOCIAL SECURITY NUMBER
 DEGREE AND MAJOR SOUGHT
APPLICANT'S FIRST NAME
 APPLICANT'S MIDDLE OR MAIDEN NAME
 APPLICANT'S LAST NAME
APPLICANT'S ADDRESS
 APPLICANT'S E-MAIL
 APPLICANT'S PHONE NUMBER
In accordance with the Family Education Rights and Privacy Act of 1974 applicants may waive their right to see letters of recommendation. Please indicate your choice and sign on the appropriate line below. If you choose to retain your right, you may read this recommendation if you enroll in the UAB Graduate School.
I waive my right to see this recommendation I retain my right to see this recommendation


SignatureDate
REQUEST TO EVALUATOR
Evaluator:
How long and in what capacity have you known the applicant?
Please compare this applicant with others you have recommended for graduate studies
Top 5% Top 10% Top 25% Top 50% Bottom 50% No basis to judge
Depth of knowledge in Proposed Field of Study
Motivation and Initiative
Diligence and Perseverance
Independence
Creativity
Dependability
Integrity
Emotional Stability
Verbal Clarity
Writing skills
Teaching Ability
Research Ability
Overall Intellectual Capability
PLEASE RETURN THIS FORM AND YOUR LETTER OF RECOMMENDATION ON OFFICIAL LETTERHEAD TO:

Dr. Ada Elgavish, Director
Genetics Graduate Program
Department of Genetics
Volker Hall 230
University of Alabama at Birmingham
Birmingham, AL 35294-0019
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