The University of Oklahoma College of Pharmacy OCAP Early Assurance Reference Form Survey

OU College of Pharmacy OCAP Early Assurance Reference Form

Thank you for agreeing to submit a reference on behalf of the requesting applicant. References are an important part of the early assurance process and are carefully reviewed. This program of study is intensive for students who wish to become pharmacists. Please complete the information and rubric below to the best of your ability. Additionally, we HIGHLY encourage additional comments with examples that support your ratings. If you have any questions or issues, please reach out to Jennifer Richardson (jennifer-richardson@ou.edu)

1.Reference Contact Information(Required.)

Reference First Name

Reference Last Name

Organization/Company/Institution Name

Address

City/Town

State/Province

ZIP/Postal Code

Email Address

2.How long have you known the applicant?(Required.)

3.In what capacity do you know the applicant?(Required.)

Instructor/Teacher/Professor

Employment Supervisor

Volunteer Supervisor

Co-worker/Colleague

Other (please specify)

4.How well do you know the applicant?(Required.)

Very Well

Moderately Well

Not Well at All