Recommendation1

OFFICE OF ADMISSIONS

Florida Southern College

111 Lake Hollingsworth Drive

Lakeland, Florida 33801-5698

(863) 680-4131 • Fax (863) 680-4120

RECOMMENDATION FORM

TO THE REFERENCE

All full-time applicants to Florida Southern College are required to submit a minimum

of one academic recommendation. This form has been provided as a guide. However,

if it is more convenient, please feel free to submit a type-written

letter.

Name of Applicant ________________________________________ Social Security Number: __________________

Address: ______________________________________________________________________________________

City/State/Zip: __________________________________________________ Telephone ______________________

Name of Reference _______________________________________ Title/Position: __________________________

Address: ______________________________________________________________________________________

City/State/Zip: __________________________________________________ Telephone ______________________

To be completed by applicant:

I hereby grant permission for the release of the information requested on this form to the Office of Admissions,

Florida Southern College (signed) __________________________________________________________________

I hereby waive all rights of access to the information contained on this form and understand that it will be kept confi-

dential between the referee and Florida Southern College (signed) ________________________________________

Dear Reference:

Thank you very much for taking your time to evaluate this candidate’s qualifications for admission to Florida

Southern College. Your recommendation will become a part of his/her admissions file.

You may use this original form or write a personal letter; however, it is not official unless it is mailed to the Office

of Admissions.

1. Your contact with this candidate is/was as a _____ teacher _____ counselor _____ employer _____ coach

_____ other (please describe)________________________

2. Have known candidate for _______ yrs. I know him/her _____ well _____ fairly well _____ slightly

3. Please check the degree to which this candidate demonstrates the following qualities:

Above Below Do Not

Excellent Average Average Average Know

A. academic ability

B. academic motivation

C. written expression

D. oral expression

E. energy and initiative

F. independence

G. originality

H. leadership

I. self-confidence

J. warmth of personality

K. sense of humor

L. concern for others

M. reaction to criticism

N. social-emotional maturity

O. adaptability

P. judgment

Q. responsibility

TO THE STUDENT

PLEASE COMPLETE BOTH SIDES OF RECOMMENDATION FORM

( )

3. Is candidate respected by his/her peers? ________.

The main factors contributing to that respect seem to be:

( ) Superiority in studies ( ) Success in athletics

( ) Leadership in activities ( ) Accomplishment in activities

( ) Interest in other students ( ) Personality

The main factors contributing to a lack of respect seem to be:

( ) Superiority in studies ( ) Conceit

( ) Lack of interest in other people ( ) Not well known

( ) Manners, personal habits ( ) Other (specify) _______________

4. Do you have unqualified confidence in this candidate’s integrity? ____

If your confidence is qualified in any way, please explain ___________________________________

_____________________________________________________________________________________________

5. General comments regarding candidate’s strengths: __________________________________________________

_____________________________________________________________________________________________

6. Comments regarding areas that need improvement: __________________________________________________

_____________________________________________________________________________________________

7. Additional Comments: __________________________________________________________________________

_____________________________________________________________________________________________

Reference’s Signature_______________________________________________________ Date ________________

Thank you for your time and effort. Please mail to the Office of Admissions at the address below:

Office of Admissions

Florida Southern College

111 Lake Hollingsworth Drive

Lakeland, Florida 33801-5698

Toll-Free: 1-800-274-4131

Office: (863) 680-4131 • Fax: (863) 680-4120

TO THE REFERENCE