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Reference Information

  • Four-Year Option and Fast-Track Option applicants: ONE reference form from an ACADEMIC source is required for all applications to the Fast-Track Option and Four-Year Option. The completed form must be sent by the referee to the Nursing Consortium Office by the March 1st deadline.
  • LPN Bridging Option applicants: must provide TWO letters of reference. One reference must be from an academic source and the other must be from an individual that can assess clinical performance. Completed forms must be sent by the referees to the Nursing Consortium Office by the February 1st deadline.
  • It is very important for applicants to select referees who can accurately speak to their potential academic ability in the Bachelor of Nursing (Collaborative) Program.
  • Please Note: reference forms from family members, family friends, co-workers, or anyone that could present a form of bias, will not be accepted.
  • Reference forms must be sent to the Nursing Consortium Office DIRECTLY from the referee, NOT the applicant, in order for form to be valid.
  • Reference forms are strongly encouraged to be emailed, however they can also be mailed or faxed to the Nursing Consortium Office. Please see our contact information for our fax number and/or mailing address.
  • Please save the blank Reference Form to your computer before you start working on it and follow the instructions on the top of the form.


(1) Applicants: fill in your full name, date of birth and Memorial student number (if known).

(2) Save the form and send the link to your referee.

(3) Referees: complete the entire form and save the file;

(4) Attach the completed form in an email to (You can also fax or mail the form to us as long as we receive it by the deadline. Please see our contact information.)

To save the form, do so by clicking on → File Save as...on the menu bar; ensure that you are saving the file in PDF format; and specify where you would like to save the file, e.g. Desktop.

PLEASE NOTE: This form is NOT always MAC compatible and therefore may require the use of another operating system.

*Notes a required field

Adobe Reader, minimum version 8, is required to complete this form. Download the latest version at:

Do not type beyond the allotted space. This form is confidential when complete and submitted.

Here is the link to the Bachelor of Nursing (Collaborative) Program Reference Form. It is also available with the online application.