REFERENCE REQUEST FORM
I am pleased to serve as a reference since this means one of my current or former students is pursuing a job, school opportunity, internship, etc. Please fill out this sheet so that I can provide the best reference possible. Since you know me well enough to ask for a reference, there is a very good chance that I also know some of the answers to these questions, but I complete a lot of references and it is very helpful to have accurate information in this readily accessible form. Also, I will keep this on hand in the event that you request another reference in the future.
*Please attach a current resume
* Please note I will only complete reference forms on which you have indicated that you have waived your right of access. This insures that the recommendation is confidential and therefore meaningful. Please also sign on the next page, again indicating that you have waived this right.
* Please provide addressed, stamped envelopes for all recipients.
* When is this reference due?
* Please remind me of this date again 3 days before the reference is due. (email, voicemail, or drop by)
What is the purpose for requesting this reference? (name company and position, name grad school, program, and degree, name scholarship, etc)
List all classes (include honor’s thesis, independent studies , and/or research ) you have taken with me as the instructor, and the grades you received in each.
We have known each other since what date (approximately)? ____________________
sports (which one(s) and when) and/or clubs (name & list offices held or special duties):
Volunteer experience(where, which semesters, and approx # hours/week):
Internships or jobs (where, which semesters, approx # hours/week) – this can be your attached resume.
What are your future plans (grad school, continue in this type of job, Peace Corps?)
Why are you interested in this particular opportunity? What will it do for you?
What are your personal and academic strengths?
Detail any special skills you have or anything else that I have not asked but you think may make you a strong candidate for this opportunity:
I ____________________________ hereby waive my right of access to all letters of reference and reference forms provided by this faculty member.