An applicant to the University of Michigan-Flint/Hurley Medical Center BSN program has requested that you complete this reference form on his/her behalf.
Please provide the following information as
objectively as possible to assist the Selection Committee. Select the
appropriate number indicating the level of ability that the applicant has in
each of the following areas that you can evaluate. Please provide an example,
if available, on the line provided below each area. Your comments are extremely important in the
student’s quest for selection into the nursing program at UM-Flint.