The code block below illustrates how one might use # and // as comments in your logic and calculations.

This value you provided is not a number. Please try again.

This value you provided is not an integer. Please try again.

The value entered is not a valid Vanderbilt Medical Record Number (i.e. 4- to 9-digit number, excluding leading zeros). Please try again.

The value you provided must be within the suggested range

The value you provided is outside the suggested range

This value is admissible, but you may wish to double check it.

The value entered must be a time value in the following format HH:MM within the range 00:00-23:59 (e.g., 04:32 or 23:19).

This field must be a 5 or 9 digit U.S. ZIP Code (like 94043). Please re-enter it now.

This field must be a 10 digit U.S. phone number (like 415 555 1212). Please re-enter it now.

This field must be a valid email address (like joe@user.com). Please re-enter it now.

The value you provided could not be validated because it does not follow the expected format. Please try again.

Required format:

jmSHmJ5PzUvsQhYNDEIc4KR9bHd7ddDZpn53xpDJiM4RduWia5wPGJIZdpEkXrooooTz56V57ftgSDyrpzLnceuZ6GH48fCHsM7YWqf7W2

STAHR Scholars Reference Form

Thank you for taking the time to submit this reference on behalf of your applicant to the UMKC STAHR Scholars Program. The STAHR Scholars Program provides students with opportunities to learn more about and prepare to become a health professional. The Scholars Program aims to strengthen students' interest in health careers and develop students into competitive applicants for health professional education programs.

All recommenders must submit this official reference form. Letters of recommendation will not be accepted in place of or in addition to this form. Please complete each section of this form. Any incomplete reference forms will not be accepted or reviewed in the application screening process.

The deadline to submit this reference form is 11:59 PM CST on February 15, 2024. Application materials, including this reference form, received after the stated deadline will be considered late and will only be reviewed if space is available.

If you have any questions about this online reference form, please reach out to the STAHR Program at stahr@umkc.edu or 816-235-6169.

Applicant/Student First Name

* must provide value

Applicant/Student Last Name

* must provide value

Applicant/Student Email:

* must provide value

Your First & Last Name:

* must provide value

Your Current Position/Role/Title:

* must provide value

Your Current Place of Employment or Involvement:

* must provide value

Your Email Address:

* must provide value

Which best describes your relationship to the applicant/student?

* must provide value

Teacher/professor/instructor

Advisor/counselor/mentor

Supervisor/employer/leader

Coworker/colleague

Peer/friend

Relative/family member

Other

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How long have you known the applicant/student?

* must provide value

COMMUNICATION SKILLS: (Effective expression of thoughts and abilities, ability to listen attentively, demonstrates patience in interactions with others, etc.)
Please describe the applicant's communication style and ability to effectively communicate:
WORK HABITS (Reliability, Self-discipline, Attention to detail, Dutifulness, Initiative, Ability to work with others, etc.)
Please describe the applicant's work habits, including whether or not you believe the applicant would be able to adjust to an intensive enrichment program without undue difficulty:
PERSONAL MATURITY AND SELF AWARENESS: (Responds well to criticism, Tolerate anxiety, Ability to resolve conflict, Recognizes own strengths and weaknesses, Maturely expresses thoughts and abilities, etc.)
Please describe the level of personal maturity and self-awareness of the applicant:
CULTURAL COMPETENCE AND DIVERSITY: (Openness to others from different backgrounds, Tolerance of opposing views, Inclusiveness of others, etc.)
Please describe the applicant's ability to work with others from different backgrounds or who have opposing views:

Any additional comments that would be helpful for the reviewing committee to know:

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FINAL RECOMMENDATION:

Based on what you know about the applicant/student, what is your overall recommendation for their fit and ability to succeed in the STAHR Scholars Program?

* must provide value

Recommend enthusiastically

Recommend

Recommend with reservations

Do not recommend

reset

Reference

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