Graduate Sciences Program Reference Form

OMB Control #0648-XXXX
Expires: XX-XX-20XX

NOAA EPP/MSI
Graduate Sciences Program

Voluntary Reference Form
Applicant Information (Please type or use black ink)
Last Name

First

Middle

In a group of 100 other science and math students of comparable age and experience, how would
you rate the applicant with respect to the following:
PERSONAL CHARACTERISTICS
Below
Average

Average

Above
Average

Outstanding

Superior

Inadequate
Observation

Motivation Toward a Productive Career
Growth During Total Period Observed
Imagination and Originality of Thought
Emotional Maturity and Stability
Ability to Work with Others
Independence and Self-Reliance
Leadership Potential
How long and in what association have you known the applicant?

In a group of 100 other science and math students of comparable age and experience, how would
you rate the applicant with respect to the following:
SCIENTIFIC CAPABILITIES
Below
Average

Average

Above
Average

Outstanding

Superior

Inadequate
Observation

Mastery of Fundamental Knowledge in Field
Skill/Originality of Research Project Design
Laboratory Skill and Technique
Ability to Communicate (Written/Oral)
PAPERWORK REDUCTION ACT INFORMATION
NOAA conducts the Office of Education, Educational Partnership Program, Graduate Sciences Program in order to promote the education and
training of students in NOAA sciences. The information contained in this reference form will be used in conjunction with the application to
select graduate students. The information on this form will not be treated confidentially. Public reporting burden for this collection of
information is estimated to average 1 hour per application including the time for reviewing the instructions and completing and reviewing the
collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including
suggestions for reducing the burden, to NOAA Office of Education, Educational Partnership Program, 1315 East-West Highway, Silver Spring,
MD 20910.
Notwithstanding any other provision of the law, no person is required to respond to, nor shall any person be subject to a penalty for failure to
comply with, a collection of information subject to the requirements of the Paperwork Reduction Act, unless that collection of information
displays a currently valid OMB Control Number.

NOAA EPP/MSI
Graduate Sciences Program

Voluntary Reference Form continued
Add any descriptive comments that will assist in providing a complete picture of the applicant's
character, attitude, abilities, and potential for research. Please comment on both the applicant's
weak and strong points. Use additional sheets if necessary.

COMMENTS:

Signature:

Date:

Typed/Printed Name:

Title:

Address:

Phone:

RETURN TO: ATTENTION: Priti Brahma; NOAA EPP/MSI Graduate Sciences Program; 1315 East West Highway, Room 10725, Silver
Spring, Maryland 20910 or FAX at (301) 713-9465.