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XXX. REFERENCE FORM "La Suerte and Ometepe Biological Field Stations"
Please print clearly or type 11/2000

To the Applicant: Please complete the top section of this form and give it to a professor or academic advisor who is well acquainted with you.

Applicants Name.................................................... PH # ( )____-______
Course name & session #...........................Ometepe/La Suerte (Circle location) Class dates....../....../.....
Applicant's signature ______________________ Today’s Date....../....../.....
Address:_______________________________
State _________________ zip)____________
E-mail address is required (please print clearly or type) -----------------------------------------
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To the Referee: The student listed above has applied to participate in an intensive ecological field study program offered by La Suerte or Ometepe Biological Field Stations. Students and faculty live and work together in a close, continuous, academic and social environment. This total immersion method presents rigorous intellectual and interpersonal challenges for both student and faculty. It is therefore important to evaluate students not only academically, but with regards to their mental, emotional, physical, and medical condition as well.
The applicant need not desire to spend the remainder of his or her life in scientific endeavors, but must be sufficiently motivated and mature to live and work productively in the setting described above. In addition to your letter of recommendation, your comments in response to the following questions will aid us in evaluating applicants and help insure the highest quality of instruction and experience for the student.

1. How long have you known the applicant?.............................................................................................................
2. In what capacity do you know the applicant (teacher, employer, etc.)? ................................................................
3. If you were the faculty member responsible for teaching the course, would you want the applicant
as a participant? Why or why not?. .............................................................................................................
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4. What are the applicant's strengths and how will these contribute to the course?
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5. What are the applicant's weakness and how would you expect these to effect his/her performance in
a field-oriented course? ...................................................................................................................…………
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6. Feel free to make any additional comments on this form or attach additional sheets if necessary.
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Please promptly forward this form directly to our U.S. address below.
Renee Lucia Molina, La Suerte or Ometepe Biological Field Station,
PO BOX 55-7519, MIAMI, FL 33255-7519
Signature ____________________________________________ Date_______________________
Name .........................................................Title...................................................
Ph # ( ) ..................... Fax ( ).........................email ………………………………………………..
Address____________________________________________________________________________________

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