Form 11 - Connecticut Bar Examining Committee

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Form 11
JULY 16
INSTRUCTIONS FOR FORMS 10 & 11
Each Form 10 and Form 11 must come directly from the reference.
Form 10 (Question 14. Personal References). Type your name on the “Applicant:” line and type the name
and address of the personal reference in the box at the top left. Do not write in the rest of the form. Mail the
form to the reference with a stamped envelope addressed to the address below. You may not use a supervisor listed
on Form 5 as a personal reference. Personal references may not be related to you or each other by blood or
marriage. If a personal reference does not respond, you may replace the reference. Notify this office in writing
which reference is being replaced and the name of the new reference.
Form 11 (Question 18. Employment). For each Form 11 type (1) on the “Applicant:” line, your name as it
appears in Question #2 of your bar application, (2) your name during employment if different from above, (3) your
social security number, (4) the position you held, (5) your dates of employment, and (6) the name and address of
the employer in the box in the upper left. Do not write in the rest of the form. Mail the form to the employer
with a stamped envelope addressed to the Committee (see address below).
In your cover letter to each employer, you should (1) emphasize the importance of returning the form promptly to
the Committee, and (2) provide the employer with any other information to identify your employment records.
Your cover letter must also specifically authorize the release of your employment information to the Committee.
It is not necessary to submit a Form 11 for military service (you must submit a DD214 as part of your answer to
Question 27), self-employment, or employment that is BOTH unpaid AND for academic credit. Do not list these
types of employment on your Form 5 – employer reference section.
If an employer is out of business, you must attempt to ascertain if its employment records remain available at
another location and attempt to have Form 11 completed by Human Resources. Send Form 11 to the last known
address of the employer. When the Form 11 is returned to you as undelivered, send it to this office with an
explanation of the effort you made to contact the employer.
If your supervisor is no longer available, you should send the Form 11 to the personnel or human resources office or
the keeper of the employment records for that employer, for verification of the dates of your employment and
position held.
The Committee suggests that you send all Form 11’s by certified mail, return receipt requested. (The return
receipt should go back to you in the first instance, not the Bar Examining Committee.) In that case, if a previous
employer fails to submit the Form 11, you can establish that you sent the form by submitting the original signed
return receipt postcard (“green card”) or, in the alternative, the original mailing receipt attached to the
printout showing the item was delivered.
List each employer from whom a Form 11 is required on the back of Form 5 in the space provided. Be sure to list
both the employer/company and the specific individual who will be completing the Form 11 (your supervisor).
Send the letters to your personal or employer references and provide them with a stamped envelope addressed as
follows:
Connecticut Bar Examining Committee
July 2016 Bar Examination
Reference Letter Department
100 Washington Street
Hartford, CT 06106-4411

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