ࡱ> gjfO <bjbjgQgQ CB;e;e  ''''';;;8stD;7.+B!-------$#02~-E'|"|"|"-''-F,F,F,|"F''-F,|"-F,F,F,LrM"RF,r-.07.F,W3#lW3F,W3'F,,|"|"F,|"|"|"|"|"--'|"|"|"7.|"|"|"|"W3|"|"|"|"|"|"|"|"|" : RECOMMENDATION FORM Counseling Services Practicum Training Program To be completed by Applicant: Applicants Name (please print): Note: Please indicate below to your evaluator whether or not you waive or retain your right of access to this recommendation. Waiving access is not required by Counseling Services. I retain my right of access  FORMCHECKBOX  I waive my right of access  FORMCHECKBOX  my right to access this recommendation.  FORMTEXT       Applicant s Signature Recommender: Please submit to: Mrs. Heather Woodall, Office Manager, DePauw University Counseling Services, Buehler Health and Wellness Suites, 1 East Olive, Lilly Center, 2033 Greencastle, IN 46135, email: heatherwoodall@depauw.edu, or fax (765) 658-4554 Name of Recommender:  FORMTEXT       Position:  FORMTEXT       In what capacities have you known the applicant?  FORMTEXT       Please share your opinion of this applicant with us. For each of the attributes listed below, use the following scale to rate this applicant and check the appropriate descriptor. 0 = cannot 1 = inadequate 3 = good 5 = excellent judge 2 = adequate 4 = very good 6 = outstanding 0123456Openness to feedback FORMCHECKBOX  FORMCHECKBOX  FORMCHECKBOX  FORMCHECKBOX  FORMCHECKBOX  FORMCHECKBOX  FORMCHECKBOX Hard-working/engaged in his/her/their training  FORMCHECKBOX  FORMCHECKBOX  FORMCHECKBOX  FORMCHECKBOX  FORMCHECKBOX  FORMCHECKBOX  FORMCHECKBOX Emotional maturity  FORMCHECKBOX  FORMCHECKBOX  FORMCHECKBOX  FORMCHECKBOX  FORMCHECKBOX  FORMCHECKBOX  FORMCHECKBOX Team player/collaborates/works well with others FORMCHECKBOX  FORMCHECKBOX  FORMCHECKBOX  FORMCHECKBOX  FORMCHECKBOX  FORMCHECKBOX  FORMCHECKBOX Time management/punctuality FORMCHECKBOX  FORMCHECKBOX  FORMCHECKBOX  FORMCHECKBOX  FORMCHECKBOX  FORMCHECKBOX  FORMCHECKBOX Written and oral skills/expression FORMCHECKBOX  FORMCHECKBOX  FORMCHECKBOX  FORMCHECKBOX  FORMCHECKBOX  FORMCHECKBOX  FORMCHECKBOX Basic therapy skills FORMCHECKBOX  FORMCHECKBOX  FORMCHECKBOX  FORMCHECKBOX  FORMCHECKBOX  FORMCHECKBOX  FORMCHECKBOX  Please use the remaining space to comment on your impression of what it is like to work with this student, their potential for clinical practicum, and areas that you consider strengths or :CUVWxy @ F G R S e i j k ʵn] jth#5OJQJU jh#5OJQJUjh#5OJQJUh#CJ OJQJ\h!VhVh#h#>*OJQJh#OJQJh#5OJQJ\h#CJ OJQJh#5OJQJ h#CJh#5CJ\ h'v^J h^J hJr^J hO^J hy^J$:UWxyj k  w %@@$IfgdyZ !(@@@$IfgdyZ *T(@@@$IfgdyZ JJ$If]^JgdyZ j(@@dh$IfgdyZ !(@$IfgdyZ n(@x$IfgdyZgd'vgd#    < @ B l x   ȳ֛֏|sibi[QJbJCi hO6CJ hKI6CJhyhe6CJ hW6CJ h S6CJhyhJr6CJh#6CJ]h#>*OJQJh#CJOJQJh#h#>*OJQJ.jh#h#5>*OJQJUmHnHu)jh#hyZ5>*OJQJUh#h#5>*OJQJ#jh#h#5>*OJQJUh#CJOJQJ^JaJh#5OJQJ > @ B D F h j }}qhh_ (@gd# `'@gd#  `'@@@gdygdJrx^`gd#[kd\$$Ifl`''0'64 la 8(A@<$IfgdyZ  b d | ~  . 2 8 : B D F p r žv^Sh#>*CJOJQJ/jh#h#>*CJOJQJUmHnHu*jh#hyZ>*CJOJQJUh#h#>*CJOJQJ$jh#h#>*CJOJQJUh#CJOJQJ hJrhJr ho'6CJhyh``@6CJ h)6CJhyhV6CJ hO6CJ hW6CJhyhJr6CJ h06CJ > @ T V X b d f /3ijzȰȥsȰȥi_RERERh'vM5CJOJQJ\h#5CJOJQJ\h#CJOJQJh'vCJOJQJ*jh#hyZ>*CJOJQJUhyCJOJQJh#OJQJh#CJOJQJh#>*CJOJQJ/jh#h#>*CJOJQJUmHnHu$jh#h#>*CJOJQJU*jGh#hyZ>*CJOJQJUh#h#>*CJOJQJj ijFf{$ !(@$Ifa$gdyZ !(@$IfgdyZ  !(@gd# ! ~#>&(@]gd# ! ~#gd#  !(@gd# )*+,-;<=>?Mǽ}iU'jh#hyZCJOJQJU'jMh#hyZCJOJQJU'jh#hyZCJOJQJU'jch#hyZCJOJQJUjh#CJOJQJUh#CJOJQJh{PCJOJQJh#5CJOJQJ\h#OJQJh#CJOJQJh#5CJOJQJ\h'vM5CJOJQJ\!,>Pbtu$%9KL^FfS !(@(($Ifgd{PFf  !(@(($IfgdyZMNOPQ_`abcqrsuӿӫӡӃo['j h#hyZCJOJQJU'jC h#hyZCJOJQJU'j h#hyZCJOJQJUh{PCJOJQJhb#CJOJQJ'j% h#hyZCJOJQJU'jh#hyZCJOJQJUh#CJOJQJjh#CJOJQJU'j9h#hyZCJOJQJU#!"#%&89:HIJLM[\]^_mӿӫӗӍo['jh#hyZCJOJQJU'j;h#hyZCJOJQJUh{PCJOJQJh:CJOJQJ'jh#hyZCJOJQJU'jh#hyZCJOJQJU'jh#hyZCJOJQJUh#CJOJQJjh#CJOJQJU'j/h#hyZCJOJQJU!mnopq ӿӫӗӃyoy['jh#hyZCJOJQJUhVHCJOJQJh{PCJOJQJ'jh#hyZCJOJQJU'jh#hyZCJOJQJU'jh#hyZCJOJQJU'jh#hyZCJOJQJUh#CJOJQJjh#CJOJQJU'j'h#hyZCJOJQJU"^p 2DVhiFf/ !(@(($Ifgd{PFf !(@(($IfgdyZ    !/0123ABCDESTUVWefgijxyӿӫӗӃoe[Qhb#CJOJQJh{PCJOJQJh:CJOJQJ'jmh#hyZCJOJQJU'jh#hyZCJOJQJU'jh#hyZCJOJQJU'j h#hyZCJOJQJU'jh#hyZCJOJQJUh#CJOJQJjh#CJOJQJU'jh#hyZCJOJQJUyzf'je"h#hyZCJOJQJU'j!h#hyZCJOJQJU'jy!h#hyZCJOJQJU'j!h#hyZCJOJQJU'j h#hyZCJOJQJU'j h#hyZCJOJQJUjh#CJOJQJUh#CJOJQJh{PCJOJQJ" '()789;<JKLMN\]^_`nopqrɿӡӍyeQ'j](h#hyZCJOJQJU'j'h#hyZCJOJQJU'jq'h#hyZCJOJQJU'j&h#hyZCJOJQJU'j&h#hyZCJOJQJUhVHCJOJQJh{PCJOJQJh:CJOJQJh#CJOJQJjh#CJOJQJU'j"h#hyZCJOJQJU(:;M_q*<=Ff1Ff+ !(@(($Ifgd{PFf$ !(@(($IfgdyZzf'ji.h#hyZCJOJQJU'j-h#hyZCJOJQJU'j}-h#hyZCJOJQJU'j-h#hyZCJOJQJUhCJOJQJ'jI)h#hyZCJOJQJU'j(h#hyZCJOJQJUjh#CJOJQJUh#CJOJQJ#'()*+9:;D~<<ӿӫӡsf\OMOUh thVCJOJQJhVCJOJQJh th'vMCJOJQJh th#CJOJQJh)CJOJQJhb#CJOJQJh th)CJOJQJh'vMCJOJQJ'j/h#hyZCJOJQJU'jU/h#hyZCJOJQJUh#CJOJQJjh#CJOJQJU'j.h#hyZCJOJQJU=>A<B<C<D<E<F<G<H<I<J<<<<<<<<<<<<<<$a$&`#$$a$gd``@  !(@xgd#  !(@gd#areas of concern. Thank you for completing this recommendation! Signature ______________________________________ Date __________________     <@<C<D<F<J<<<<<<<<<<<<<<<<ľhyZ hyZCJ hyZ0JCJOJQJhs,jhs,UhJrhyhkhbh'vMCJOJQJh tCJOJQJ<<A0PrPr&P:pyZ@P / =!8"8#`$@%  tDeCheck1tDeCheck2tDText2u$$If!vh#v':V l0'65'4tDText3tDText5tDText7J$$If!v h#vL#v#v#v#v#v#v#v#v :V l405L55555555 / / / / / / /  4f4kd/$$Ifl4 q!/ #>&L0$$$$4 laf4tDeCheck7vDeCheck15vDeCheck23vDeCheck31vDeCheck39vDeCheck47vDeCheck55J$$If!v h#vL#v#v#v#v#v#v#v#v :V l405L55555555 / / / / / / /  4f4kd $$Ifl4 q!/ #>&L0$$$$4 laf4tDeCheck8vDeCheck16vDeCheck24vDeCheck32vDeCheck40vDeCheck48vDeCheck57J$$If!v h#vL#v#v#v#v#v#v#v#v :V l405L55555555 / / / / / / /  4f4kd$$Ifl4 q!/ #>&L0$$$$4 laf4vDeCheck10vDeCheck18vDeCheck26vDeCheck34vDeCheck42vDeCheck50vDeCheck58J$$If!v h#vL#v#v#v#v#v#v#v#v :V l405L55555555 / / / / / / /  4f4kdu$$Ifl4 q!/ #>&L0$$$$4 laf4vDeCheck11vDeCheck19vDeCheck27vDeCheck35vDeCheck43vDeCheck51vDeCheck59J$$If!v h#vL#v#v#v#v#v#v#v#v :V l405L55555555 / / / / / / /  4f4kd$$Ifl4 q!/ #>&L0$$$$4 laf4vDeCheck12vDeCheck20vDeCheck28vDeCheck36vDeCheck44vDeCheck52vDeCheck60J$$If!v h#vL#v#v#v#v#v#v#v#v :V l405L55555555 / / / / / / /  4f4kdQ#$$Ifl4 q!/ #>&L0$$$$4 laf4vDeCheck13vDeCheck21vDeCheck29vDeCheck37vDeCheck45vDeCheck53vDeCheck61T$$If!v h#vL#v#v#v#v#v#v#v#v :V l4(05L55555555 / / / / / / /  4f4yt{Pkd)$$Ifl4( q!/ #>&L0$$$$4 laf4yt{PvDeCheck14vDeCheck22vDeCheck30vDeCheck38vDeCheck46vDeCheck54vDeCheck62J$$If!v h#vL#v#v#v#v#v#v#v#v :V l405L55555555 / / / / / / /  4f4kdA0$$Ifl4 q!/ #>&L0$$$$4 laf4w2 0@P`p2( 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p8XV~ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@6666_HmH nH sH tH D`D #NormalCJOJQJ_HmH sH tH DA`D Default Paragraph FontRi@R  Table Normal4 l4a (k (No List 4@4 #Header  !4 @4 #Footer  !.)@. # Page Number:": # Footnote TextCJ4>@24 #Title$a$5CJXB@BX # Body Text *T(@@@CJOJQJ\^JaJd"@d #Caption" (@"^`"5CJOJQJ]^JaJH bHF .0RevisionCJOJQJ_HmH sH tH HrH F . Balloon TextCJOJQJ^JaJN/N F .Balloon Text CharCJOJQJ^JaJPK![Content_Types].xmlN0EH-J@%ǎǢ|ș$زULTB l,3;rØJB+$G]7O٭VGRU1a$N% ʣꂣKЛjVkUDRKQj/dR*SxMPsʧJ5$4vq^WCʽ D{>̳`3REB=꽻Ut Qy@֐\.X7<:+& 0h @>nƭBVqu ѡ{5kP?O&Cנ Aw0kPo۵(h[5($=CVs]mY2zw`nKDC]j%KXK 'P@$I=Y%C%gx'$!V(ekڤք'Qt!x7xbJ7 o߼W_y|nʒ;Fido/_1z/L?>o_;9:33`=—S,FĔ觑@)R8elmEv|!ո/,Ә%qh|'1:`ij.̳u'k CZ^WcK0'E8S߱sˮdΙ`K}A"NșM1I/AeހQתGF@A~eh-QR9C 5 ~d"9 0exp<^!͸~J7䒜t L䈝c\)Ic8E&]Sf~@Aw?'r3Ȱ&2@7k}̬naWJ}N1XGVh`L%Z`=`VKb*X=z%"sI<&n| .qc:?7/N<Z*`]u-]e|aѸ¾|mH{m3CԚ .ÕnAr)[;-ݑ$$`:Ʊ>NVl%kv:Ns _OuCX=mO4m's߸d|0n;pt2e}:zOrgI( 'B='8\L`"Ǚ 4F+8JI$rՑVLvVxNN";fVYx-,JfV<+k>hP!aLfh:HHX WQXt,:JU{,Z BpB)sֻڙӇiE4(=U\.O. +x"aMB[F7x"ytѫиK-zz>F>75eo5C9Z%c7ܼ%6M2ˊ 9B" N "1(IzZ~>Yr]H+9pd\4n(Kg\V$=]B,lוDA=eX)Ly5ot e㈮bW3gp : j$/g*QjZTa!e9#i5*j5ö fE`514g{7vnO(^ ,j~V9;kvv"adV݊oTAn7jah+y^@ARhW.GMuO "/e5[s󿬅`Z'WfPt~f}kA'0z|>ܙ|Uw{@՘tAm'`4T֠2j ۣhvWwA9 ZNU+Awvhv36V`^PK! ѐ'theme/theme/_rels/themeManager.xml.relsM 0wooӺ&݈Э5 6?$Q ,.aic21h:qm@RN;d`o7gK(M&$R(.1r'JЊT8V"AȻHu}|$b{P8g/]QAsم(#L[PK-![Content_Types].xmlPK-!֧6 0_rels/.relsPK-!kytheme/theme/themeManager.xmlPK-!g theme/theme/theme1.xmlPK-! ѐ' theme/theme/_rels/themeManager.xml.relsPK] B   Mm y<<  j ^=<<  8DJWci*,<>NP`br"9IL\^np  02BDTVf(8;KM]_oq    ( * : G$G$FFFFG G G G G G G G G G G G G G G G G G G G G G G G G G G G G G G G G G G G G G G G G G G G G G G G G 8@0(  B S  ?5Text2Text3Text5Text7Check7Check15Check23Check31Check39Check47Check55Check8Check16Check24Check32Check40Check48Check57Check10Check18Check26Check34Check42Check50Check58Check11Check19Check27Check35Check43Check51Check59Check12Check20Check28Check36Check44Check52Check60Check13Check21Check29Check37Check45Check53Check61Check14Check22Check30Check38Check46Check54Check629X -?Qc:M_q!3EW)<N`r  +   !"#$%&'()*+,-./01234Kj+=Oas#J]o 1CUg9L^p  ) ; F! 11:UVV@FGRSe6<Ay!##88KKLLMMllmn/3CC+,=>OPabs#%&889JL]^op  12CDUVgi'(9;LM^_pq    ) * ; ~ : @ D 11:UVV@FGRSe6<Ay!##88KKLLMMllmn/3CC+,=>OPabs#%&889JL]^op  12CDUVgi'(9;LM^_pq    ) * ; ~ : @ D EDNa{ KIu} VenMJ.X!>J"b#+L$F ./.0 2%E3N|5dx<)]@``@VHj2I'vMOQ*qQAjR He3j,9lJrwao'[9#kJEG}s,)J{PEV:  <'v tyZW!Vb%Cy'3 S @@ @ @x@UnknownG.[x Times New Roman5Symbol3. .[x ArialA. Arial Narrow5. .[`)TahomaC.,.{$ Calibri Light7..{$ CalibriA$BCambria Math"hOS'OS' *G!8`9r4 3QHP ?#2!xx"mf RECOMMENDATION FORMGALLAHAJHeather Woodall Oh+'0  4 @ L Xdlt|RECOMMENDATION FORM GALLAHAJNormalHeather Woodall2Microsoft Office Word@F#@HiI@jM@jM ՜.+,0 hp  UWEC  RECOMMENDATION FORM Title  !#$%&'()*+,-./0123456789:;=>?@ABCDEFGHIJKLMNOPQRSTUWXYZ[\]_`abcdehilRoot Entry FsMk@Data "u31Table<W3WordDocument CBSummaryInformation(VDocumentSummaryInformation8^MsoDataStore@qM%rMQMO2YZLO1EBYI==2PqM%rMItem  PropertiesUCompObj r   F Microsoft Word 97-2003 Document MSWordDocWord.Document.89q