be completed by the applicant before recommendation is given to referee.
As per my rights under the U.S. Family Educational Rights and Privacy Act of 1974:
It is my desire that this letter be CONFIDENTIAL and I wish to waive my
rights of access to this letter, once received by the Graduate Program.
Applicant's Signature_______________________________________ Date_______________
Instructions to Writers of Professional References
______________________________ is applying for admission to the Graduate Program in Computer Information Science at La Salle University.
The candidate has indicated above whether this reference is to be CONFIDENTIAL or NON-CONFIDENTIAL: a non-confidential reference will be so designated by the Graduate Program and may be shown to the candidate. Do not make any statements until the applicant has completed the above portion of this form.
please return to:
___________________________________________ is applying for entrance to the Graduate Program in Computer Science. He/She has submitted your name. Would you please take a few minutes to fill out this form and mail it to the above address?
How well do you know the applicant? (Please check appropriate space)
a good deal of time with the applicant and know him/her well.
Daytime Telephone Number___________________________________________
Title or Position_____________________________________________________