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RECOMMENDATION
FORM: Due on March 1
Applicant: The form is used to help evaluate your potential
in the Graduate Program. Complete the top portion of the form first.
Provide an envelope and form to everyone you are asking for a recommendation.
(Feel free to make extra copies of the form if needed). Once complete, the
recommender should place the form and letter (if letter is desired) in an
envelope, then seal and sign the flap. Sealed envelopes may be enclosed in the
application package or sent separately to be received on
March 1: Graduate
Program in Communication Studies, Department of Communication, Portland State
University, P.O. Box 751, Portland, Oregon 97207-0751.
Applicant's name ____________________________________________
Address ____________________________________
_______________________________
Recommendation
requested for [
check all that apply]
o
graduate admission
o
teaching assistantship
o
research assistantship
Release
of access to the letter of recommendation
The applicant must
complete and sign the following statement before giving the form to the
recommender. The request is in compliance with Federal Law (Family Educational
Rights and Privacy Act of 1974).
CHECK ONE BOX ONLY
o
I hereby voluntarily waive and relinquish any right
of access to this letter OR
o
I retain my rights of access to this confidentialletter of recommendation
Applicant's signature ________________________________________
Date _______________________________
TO THE RECOMMENDER
Thank you for taking
time to complete the form. The form is used to help assess the candidate~Rs
ability to succeed in graduate school. You may also write a separate letter ofrecommendation or use the other side of the form to provide additional insight
into the candidate~Rs abilities. Please enclose materials in an envelope, then
seal and sign the flap. You may return the envelope to the applicant or send itto the Communication Studies Graduate Office at the address above.
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