Letter of Recommendation

Request Form
HELP TEACHERS HELP YOU

Dear NOTE TO STUDENTS: Please personally ask a teacher to write a letter of recommendation for you. This form is
________ designed to help the teacher write the letter. If the teacher agrees to write the letter, you may present this form to
________ provide more information about yourself. Please bring a copy of it to the College Counseling Office once it’s filled.
________ Please use an additional sheet if needed for any part of the form.
________
,

Would you please consider writing a letter of recommendation for me to include with my college and/or scholarships
applications? Below, you’ll find some information about me.

Thank you in advance,

Student Name: __________________________________ Class: _____ Date: ___________

Student Signature _______________________________ Date letter is needed by: ________________

Career/s I am considering for my future and the reasons why I am drawn to this field/these fields:
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________

Colleges I am planning to make applications:

___________________________________________________________________________________
___________________________________________________________________________________

Top accomplishments, awards and honors I have earned:

___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________

Clubs/Sports/Activities in High School (including which year(s) for each, and any leadership role I have had or I
am fulfilling)
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
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Some of the volunteer work I participated, when they took place and estimated hours I spent.
___________________________________________________________________________________
___________________________________________________________________________________

A problem I faced and how I overcame it:

___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
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What makes me happy?

___________________________________________________________________________________
___________________________________________________________________________________

What makes me feel uncomfortable?

___________________________________________________________________________________
___________________________________________________________________________________

My hobbies:
___________________________________________________________________________________
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Three important adjectives that accurately describe me (with a brief example of each):
1._________________________________________________________________________________
___________________________________________________________________________________

2._________________________________________________________________________________
___________________________________________________________________________________

3._________________________________________________________________________________
___________________________________________________________________________________

I asked my friends to write three adjectives that they think accurately describe me. Here is what they wrote for
me (with their own handwriting):
___________________________________________________________________________________

Is there anything else you’d like to mention?

___________________________________________________________________________________
___________________________________________________________________________________
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