Letter Of Recommendation Request Form printable pdf download

Letter Of Recommendation Request Form

Letter of Recommendation Request Form

(jpg revised 3/15)

Return this form, along with the Permission Document (waiver), to Faculty letter writer

at least 2 weeks prior to due date.

Name: __________________________________-________ Date: _______________

Do you waive your right to see your letter of recommendation? YES ___ NO ___

Deadline for letters: _____________________ ** allow at least 2 weeks, 3 preferred

Address: ________________________________ Tel #: _______________________

________________________________ Email: _______________________

Academic Record

Total # hours completed: ________ Total # of hours in psychology: __________

Overall gpa: ________ Psychology gpa: _______ Last 2 years gpa (optional): ______

Standardized test scores (e.g., GRE): _________________________________________

Major: __________________ Minor: ______________ Date of Graduation: ________

List classes taken and grades received from the instructor who will write your letter:

* For the info below, provide estimate of the number of hours worked (e.g., “10

hours/week (total 100 hours), working as a student mentor, Winter qtr, 2005”)

* Student Activities

Honors/Clubs/Activities/Awards

* Experience

Psychology related experience (e.g., research work; 693; include duties/responsibilities)

Off campus work experience (e.g., volunteer work; other work experience)

Family responsibilities (and/or special circumstances that you want mentioned in your

letter)

Letter Of Recommendation Request Form