Name:______________________
Date:__/__/____
Program (check one)
Selected Studies:
Honors:
Year (check one)
Freshman:
Sophomore:
Junior:
Senior:
Major or Field:______________
GPA:______________(if known)
Person Making Recommendation:______________________
Department:______________
Phone:______________
Extent of your acquaintance with the
student:
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
Is this student academically above average?
What characteristics lead you to believe that he/she
would do well in the Program?
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
Please comment specifically, if you can,
about the student's writing abilities:
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
Other Comments:
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
Signature:________________
Date:__/__/____
Please return this form to the Honors Office, SL 504B.
