Teacher Recommendation Form printable pdf download

Teacher Recommendation Form

Applicant Information

Name: ________________________________________________________________ Gender: M / F

First

Middle

Last

Date of Birth: ___________________________ Social Security # _____________________________

mm/dd/yyyy

Optional

Address:___________________________________________________________________________

Number & Street

City/Town

State

Zip Code

Country

Current School:_____________________________________________ CEEB Code______________

IMPORTANT PRIVACY NOTICE: Clarkson University does not save recommendations post-matriculation.

Signature:_________________________________________________ Date____________________

Teacher Information

Name: ______________________________________ Subject/Course: ________________________

Signature: ________________________________________________ Date____________________

School Name ______________________________________________________________________

School Address:____________________________________________________________________

Number & Street

City/Town

State

Zip Code

Country

Telephone # ( ____ ) ________________ Ext. ________ Email: _____________________________

How long have you known this student and in what context? _________________________________

What words do you think best describe this student? _______________________________________

List the course you have taught this student, noting for each the student’s year in school and the level

of course difficulty (AP, IB, Accelerated, Honors, etc.).

_________________________________________________________________________________

Teacher Recommendation Form