LETTER OF RECOMMENDATION

APPLICANTS PERSONAL INFORMATION

Name: _____________________________________________________________________________________________
Last
First
Middle

UT Dallas NET ID: _______________

Entering Semester: ________________

Collegium V is a comprehensive program of academic enrichment and recognition for outstanding students. In reviewing the
qualifications of Collegium V applicants, the selection committee is particularly interested in a students intellectual curiosity,
self-discipline, creativity and commitment to learning. Specific examples that illustrate the applicants academic promise are
especially helpful in the selection process. Please note that we have a limited number of slots in the program. Applications will
not be considered until both letters are received. To learn more about Collegium V, please visit honors.utdallas.edu/cv/

I certify that the attached information is accurate and complete:

Recommenders Name:
(Please print)

_____________________________________________________________________________
Last
First

Position:

____________________________________________________________________________________

Institution:

____________________________________________________________________________________

Telephone:

____________________________________________________________________________________

Email:

____________________________________________________________________________________

Signature:

______________________________________

Please return all materials to:

Collegium V Honors Program
helen.roth@utdallas.edu
Or
Collegium V Honors Program
The University of Texas at Dallas
800 W. Campbell Rd. GC 10
Richardson, TX 75080-3021

__________________________________
Date