Reference Letter Request Form:
Student Information Worksheet
• Think of teachers who know you well.
• Student Information Work-Sheet
– Fill out the work-sheet as completely as possible
– Not all sections may apply to every student
– Fill out one work-sheet per reference letter
requested
• Written Statement
– Create a written statement describing yourself
by including:
• Your academic interests / plans for the
future
• Your strengths
• Attitude and/or skills which may help you
be academically successful in your post-
high school plans
– Attach your written statement to this worksheet
• Make an appointment to ask the teacher /
teachers to write a letter of
recommendation for you.
– Plan ahead to meet your timeline
– Allow each teacher 10-14 days for the
completion of the letter
– DO NOT assume the letter will be completed if
you leave the request in the teacher’s mailbox.
– Make sure you make a personal contact with the
teachers
• During the appointment provide:
– A self addressed, stamped envelope
– Completed information work-sheet
• Thank You Letters:
– Write a short “Thank You” letter (note) to the
teachers who have supported you and provided
a reference letter
– “Thank You” letters (notes) may be e-mailed to
the teachers utilizing their school e-mail
addresses
Student: When requesting a letter of
recommendation from a
teacher, be aware to:
Student Instructions:
• Student’s Responsibilities:
– A completed Student Information Worksheet
(opposite side)
– Addressed, stamped envelope
• Student Criteria you may wish to consider:
– Scholastic ability
– Motivation
– Reaction to Criticism
– Initiative
– Emotional Stability
– Personality
– Integrity
– Cooperation
– Maturity
– Leadership Qualities
• Other Considerations, you may wish to
include:
– Examples or Anecdotes
• Illustrating the student’s character
• Illustrating the student’s judgment
– Accuracy of “First-Impression”
• Do you feel the same?
• Why?
– Why this particular school is a match for the
student
– Other faculty members comments / input
– Comparison w/ previous candidates
• Personal Information:
– Phone Number – for further information about
this student
– High School contact information
• Additional Copies:
– Xerox a copy in case another letter is needed for
this student
Please Note: In order to assist you with a
meaningful letter of recommendation, the
student has been asked to fulfill their
responsibilities.
Faculty Instructions:
Suffield High School
1060 Sheldon Street
West Suffield, CT 06093
Phone: 860-668-3810
*Remember to attach your personal statement before giving this form to the person you'll be requesting a letter from!