St. Luke’s Medical Center Galleue of Medicina Williom H. Quasha Memorial RECOMMENDATION Master of Science in Molecular Medicine NAME OF APPLICANT: (Lastname, First name, Middle name) GENDER: ) Male Female Sir/Madam: ‘The applicant named above has applied for admission to the Master of Science in Molecular Medicine program ofthe St. Luke’s | Medical Center College of Medicine and has listed you as a referee. We would appreciate it very much if you could complete this | evaluation form according to your best knowledge and return it to the SLMCCM WHQM Graduate Office on or before You may use a separate sheet to give a narrative of addtional information about the applicant. Please use the ‘envelope provided and mail or hand-carry to the SLMCCM WHIM Graduate Program ‘Thank you very much. Please rate the applicant according! 1 0 5 4 3 2 1 ATTRIBUTES 5 CANNOT EXCEPTIONAL| SUPERIOR] AVERAGE| FAIR | POOR | evaluate 1. Intellectual ability | Research capability | Capacity for eritical/analytical thinking Leadership qualities “Motivation for graduate studies Emotional stability Diligence in study or habits Teaching poten Resouresfulness and creativity 1 [10 Honesty and integrity recommend the candidate to the Master of Science in Molecular Medicine program Clvery strongly O strongly. [C11 do not recommend the candidate to the Master of Science in Molecular Medicine program. [ipa eae ra One NAME: (Lastname, First rane, Midi name) POSITION/RANK/TITLE: INSTITUTION TEL. NO. E-MAIL ADDRESS: ‘ADDRESS iP CODE FAXNO NUMBER OF YEARS YOU HAVE KNOWN THE APPLICANT IN WHAT CAPACITY 1D Professor Di Supervisor/Employer Others, specify Sa lgraaana St Cabaral Haight, Guzon Cay 1102 Phipinee Mp atucoemedenlge adi pl Era regearQatutcuneacolge of 2h