Teacher Recommendation Request Form

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TEACHER RECOMMENDATION REQUEST
Student's Name __________________________________________ Today's Date:______________________________________
Date Recommendation is due: _______________________________________________________
Student's Age:_______________________E-mail Address / Phone # (in case of questions)___________________________________
Teacher's Name:________________________________________Class_______________________________________________
Name of College/Scholarship Program:_________________________________________________________________________
__________First request (must be made at least 10 school days prior to the deadline)
__________Additional request (must be made 5 school days prior to the deadline)
__________Stamped, pre-addressed envelope is attached
__________ Letter of recommendation should be returned to the counselor to mail with application materials.(Choose this option
only if the application requires all material be mailed be mailed in one package).
I request that you submit a recommendation in support of my application to the above named institution. I understand that is
recommendation is confidential, and I hereby waive any rights I may have to review its contents.
Student’s Signature__________________________________________________________
Parent’s Signature___________________________________________________________ (required if student is not 18)
This information may be helpful to you as you write the recommendation.
1.
These are some of the things I want the college admissions and/or scholarship committee to know
about me ......
2.
The specific things I hope you will discuss in this letter.
3.
What I remember most about your class.
To assist the teacher in writing your recommendations include specific examples of your work on activities, papers, projects,
etc. that you did while enrolled in his/her class.
You may attach a resume to this form if you wish, but remember that the
.
teacher recommendation will focus on activities you did as a student in this teacher’s classroom

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