RECOMMENDATION FORM

To the applicant: Letters must be in typewritten format. Applicants must complete the top portion prior to sending
to each recommender. Be sure to include your printed name, signature, date & select a waiver option on each form!
This form should be given to an individual under whom you have studied or worked & who is able to comment on your
qualifications for graduate study. This form can be faxed to  or emailed to LMBSPDDB!VUJDBFEV by either the
applicant or the recommender. * = Required Field.

* Applicant name ___________________________________________________________________________________

Under the provisions of the Family Education Rights & Privacy Act (check one).
I have retained the right to access this recommendation.

I have waived the right to access this recommendation.

* Applicant signature __________________________________________ * Date _______________________________

To the recommender: Please be sure to complete all fields & sign where indicated. Electronic or hand-written
signatures are acceptable. On the narrative section (page 2), please provide a narrative description of the applicant’s
qualifications for graduate study. In this regard, please include an assessment of how this applicant compares to others
whom you have taught, or with whom you have worked. Please fax completed form & narrative to 866-789-5605 or scan &
email to LMBSPDDB!VUJDBFEV. Note that the applicant may be under deadline to provide this recommendation. Thank you!

* Name of Recommender ____________________________________________________________________________

* Signature ________________________________________________________________________________________
* Address __________________________________________________________________________________________
* Position ___________________________________________ * Organization __________________________________
* Daytime Telephone (___________) _____________________ * Date _________________________________________
* Relationship to Applicant ____________________________________________________________________________
Please give your appraisal of the applicant in terms of the qualities listed below.

Top 3% Next 10% Next 20% Middle Third Lowest Third Unable to Judge

Intellectual Ability

Analytical Ability

Imagination/Creativity

Organizational Ability

Written Communication

Oral Communication

Ability to Solve Complex Problems

Initiative

Persistence/Drive

Ability to Work Independently

Computer Proficiency

programs.online.utica.edu
 RECOMMENDATION FORM

Narrative description of the applicant’s qualifications.

(This must be typed.)

programs.online.utica.edu