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Academic / Scholarship Recommendation Request
Student name:
Letter to be written by ________________________ (individual) on or before ___________ (date).
The letter of recommendation is for (check one):
_____ College admission
_____ Scholarship*
_____ Other:
* List any special personal or family circumstances that have caused financial difficulty: ________
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Please identify the individual, group or name of committee to receive the letter: _______________
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The letter should be returned to Mrs. Sarah Jimenez in the College Counseling Office.
Any questions should be directed to the student’s counselor. Please consider the suggestions
provided on the reverse side of this form.
Thank you for your time and effort on behalf of this student.
Student Information
Please provide detailed information listed and provide grade when involved.
Please list five adjectives that best describe you:
1.____________
2. ____________
3. ____________
4. ____________
5. ____________
School related clubs, organizations, and activities: _____________________________________
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Community clubs/organizations/groups, religious activities, volunteer projects, etc.: __________
________________________________________________________________________________
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Jobs or work experience: _________________________________________________________
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Awards, honors, accomplishments, positions of responsibility: ___________________________
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(See backside.)