Reference Letter Request Form


Reference Letter Request Form: Professor __________, English Department
Dear students: We usually write references for people who’ve performed well in our classes and/or
excelled at completing projects under our direction. Positive interactions and superb performance are
key. If you feel I’d be a suitable reference for you: (1) please ask me at least three ~ 3~ weeks in advance
of the deadline so I can write the best possible reference for you;
(2) please fill out this form (electronic or print) & attach relevant documents;
(3) please e-mail or place completed materials in my department box.
Your name:
Student ID#:
Campus Box:
Preferred Phone#:
Today’s Date (Mo/Day/Yr):
Reference Letter Deadline (Mo / Day / Yr):
Do wish you to waive or retain your access to the letter? __ Waive __ Retain
Note: To learn more about the pros/cons of waiving or retaining, refer to this helpful site from Cornell University:
1. Please describe your goals:
2. Specific courses you’ve taken that you’d like me to mention in your letter:
3. Academic, professional, and extracurricular experiences:
4. Other specific information you’d like me to highlight in your letter:
Please list addresses and deadlines for each letter request. Use additional pages if necessary.
Appropriate Salutation
(To the Admissions Committee, Dear Prof. Urquhart, To Sir or Madam, etc.)
Name of University, Institution, or Employer:
Please check one of the following:
__ University or employer will contact professor by e-mail about submitting an on-line reference.
__ Professor should mail a paper copy of the letter to the above address.*
__ Professor should use the attached ref. form & mail a paper copy to the above address.*
Please provide a stamped, addressed envelope.
Every good and perfect gift is from above, coming down from the Father of the heavenly lights,
who does not change like shifting shadows. (NIV, James 1.17)


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