Social Work Program Professional Reference Form

The student named below has requested that you provide a professional reference for their admission to the Social Work Program at Northwestern Oklahoma State University. We seek students who demonstrate potential for academic work as well as a strong commitment to the welfare of all. Northwestern's social work program is designed to prepare graduates for the generalist practice of professional social work. BSW's have the knowledge, values, and skills to work with individuals, families, organizations, and communities to improve the quality of life for all, while maintaining high standards of ethical behavior. We appreciate your assistance in providing a candid, professional assessment of the student's qualifications for the profession of social work. Please list your relationship to the applicant in professional terms (i.e. supervisor, instructor, co-worker, manager, committee member, volunteer coordinator). The use of terms like family friend, student, baby-sitter, etc. will disqualify your reference for this student.

My Section

Rate the applicant:

Academic skills for college work: *
Judgment and maturity needed to work with vulnerable clients: *
Values consistent with professional social work: *
Insight and self-awareness: *
Commitment to social justice: *
Ability to work with others: *
Do you recommend this student for admission? *

Reference's Contact Information


 I hereby certify that the answers and statements contained in this reference are true to the best of my knowledge and belief. Checking this box serves as your digital signature.

After clicking on the submit button below, your reference form will be emailed to the Department of Social Work and filed in the student's admissions application. Thank you for your time.

Northwestern Oklahoma State University

709 Oklahoma Blvd., Alva, OK 73717
Phone: (580) 327-1700

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Mission Statement

Northwestern Oklahoma State University provides quality educational and cultural opportunities to learners with diverse needs by cultivating ethical leadership and service, critical thinking and fiscal responsibility.

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