Student/Graduate’s Full Name

_____________________________________________

I hereby request that ______________________________________
provide a letter of recommendation for my application for employment or graduate school. I give permission to this individual to provide any information he or she deems relevant regarding my application.

______________________________________

Student/Graduate Signature

_______________________________________

Date

Requestor of Recommendation Letter:

Please print this form out sign and date it and deliver it by hand or mail to the person from whom you are requesting a letter of recommendation.

Writer of Recommendation Letter:

Please return this signed form to the Office of Career Services.