Recommendation Request Form Haverford College printable pdf download

Recommendation Request Form

Haverford College

Prehealth Process

Section 1 – To be completed by the student

Name of student____________________________________________ Class_________________________

Name and title of recommender________________________________________________________________

Place of employment of recommender___________________________________________________________

I understand that a copy of the recommendation attached to this statement will be forwarded, at my request, to the admissions

offices of professional schools of the health sciences. A copy of this recommendation may also be used in support of my

candidacy for prizes or awards for which I may be nominated, or for fellowships, grants, or positions for which I may apply. I

specifically grant the recommender permission to include my grade point average and grades in the recommendation. (This

statement is provided in connection with the Family Educational Rights and Privacy Act of 1974.)

Check one:

____ This is a confidential recommendation and will not be made available to me without prior consent of the author of the

recommendation

____ I retain my right of access to this letter of recommendation

Signed __________________________________________________ Date___________________

Section 2 – To the Recommender

Please sign and date this form and then return this form with your letter. Please find the guidelines for composing

and submitting your letter below

Recommender’s signature__________________________________ Date___________

All letters should be addressed generally (i.e. ‘Dear Admissions Committee’) and should appear on

letterhead with a scanned or handwritten signature. Please send your letter with this completed form and

email it to Leslie Wood (lwood@haverford.edu) or mail to Haverford College, Health Professions Advising,

Stokes Hall 300, 370 Lancaster Ave., Haverford, PA 19041-1392.

In your letter of recommendation please explain your relationship the candidate with reference to how you know him/her and

in what capacity you have interacted. If applicable, please comment on the following if you have observed the behaviors

directly:

Personal attributes



Ethically responsible to self and others, honesty, integrity, social responsibility and service orientation



Motivation for the health career chosen



Ability to communicate and work collaboratively as part of a team



Professionalism and personality; maturity, reliability, compassion, flexibility, independence, self-reliance, sense of humor, leadership



Sensitivity to others of diverse backgrounds; ability to work with a diverse population



Resilience and adaptability

Academic (if applicable)



Academic performance and ability



Intellectual curiosity; skills in research, critical thinking, quantitative reasoning and scientific inquiry



Rigor of the courses(s) taken with you



Distinctive contributions this applicant has made



Attitude and approach to course activities in and outside of class



Group or teamwork skills

Recommendation Request Form Haverford College

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