Letter Of Recommendation Release

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University of Utah Le er of Recommenda on
Permission to Release Educa on Record Informa on
Please submit this form to the individual who you have requested the Le er of Recommenda on from.
Student Name: _________________________________
Student ID Number: ____________________
I authorize ________________________________________ to write a le er of recommenda on on my behalf to:
Recipient Name
Address
Phone number
Email
The following informa on may be included in the recommenda on le er (mark all that apply):
Grades
Courses A ended
GPA
Academic Performance
Class Rank
Other: _________________________________________
Check one:
I waive
I do not waive my right to review a copy of the le er at any me in the future.
Student Signature
Date
Note: please assist the faculty member in preparing your reference by providing suppor ng informa on along with your request.
Examples of informa on that might be helpful: a resume, a transcript, samples of previously completed academic work, etc. and informa on
about the graduate program or posi on for which you are applying.
This form is being provided to assist you and your faculty in the permission process for student recommenda ons and references. The form
has been dra ed using the sample le er provided by the American Associa on of Collegiate Registrars and Admissions Officers (AACRAO)
and complies with the Family Educa onal Rights and Privacy Act (FERPA) which requires wri en permission before releasing student
informa on to a third party.
It is recommended that this release be kept on file for at least one (1) year. If you have ques ons concerning the confiden ality and release
of student informa on, please contact the Registrar’s Office at (801) 585‐1735 or by email at registrar@sa.utah.edu.
Updated: 01/19/2012

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