Easterns Illinois University Admissions Recommendation Form

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Admissions Recommendation Form 
 Office of Admissions 
600 Lincoln Ave. Charleston, IL 61920. (217) 581‐2223 office (217) 581‐7060 fax 
 
 
 
1. Name of Student (print):
                     
 
                                                              Date of birth :     
 
   
:  
To the Evaluator
Please rate the candidate on the following characteristics and answer the questions.   
Personal comments can be typed or handwritten in the space below. This evaluation will become part of the  
student’s admissions file. Please return or fax the completed reference form directly to the Office of  
Admissions at the above address. We may contact you for further information.  
 
 
 
 
Above 
Unable to 
Characteristic 
Excellent 
Average 
Poor 
Average 
Rate 
Academic Ability 
 
 
 
 
 
Attitude 
 
 
 
 
 
Initiative 
 
 
 
 
 
Oral Communication 
 
 
 
 
 
Potential for Success 
 
 
 
 
 
Problem Solving 
 
 
 
 
 
Reading Comprehension 
 
 
 
 
 
Quality of Writing 
 
 
 
 
 
 
How long have you known the student?              year(s)          month(s)                                                                                                          
In what capacity (teacher, counselor, etc.) do you know the student?       
 
      Subject:               
                                
How well do you know the student?       Very Well           Fairly Well          Casually           Unable to Rate 
Would you please address this student’s academic preparedness/motivation to be successful in college:       
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Signature of person completing form:   
 
 
                       Date:                                                                   
Name (print):   
 
 
 
        
  Position/Title:                                                  
 
Institution/Affiliation name:     
 
 
 
                                  
                        
                            
Email address: ______________________                  _____________ Phone #:     ____________________             
The Family Educational Rights & Privacy Act of 1974 opens many records for the student’s inspection.  The Law also permits the student to sign a waiver relinquishing 
personal rights to inspect letters of recommendation.  Call to determine if this candidate has waived their right to view this recommendation form. 

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