Student Questionaire: Information needed for a letter of recommendation to be written.

Applicant Information:

Your Name (as you want it to appear on your letter):___________________________

Your social security number (only if required on your letter): _ _ _ - _ _ - _ _ _ _

Type of position (program, fellowship, job, ...):________________________________

Addressee(es) of the person(s) to whom I should write (block form, left justified): (Alternatively, preaddressed envelopes would be appreciated)

Education: (Attach unofficial transcripts for significant transfer credits).

Current GPA (attach unofficial transcript): _____________________

List the names, numbers, and dates of all courses you took with me. (If you were my research advisee, how many credit hours/semester).

Course

Semester/Year (credit hrs)

Grade

If you’ve done, or are currently doing, research in a lab (mine or anyone else’s), briefly describe the project(s) and your significant contributions, results or conclusions. Include internships, was any of this work paid?

Broader Aspects:

Briefly describe your career plans and professional interests. What role does the program/ position for which you are applying play in these plans?

Tell how your experiences and background (both academic and nonacademic) qualify or prepare you for this program/ position.

What can I say about you that will demonstrate your sincere interest in your chosen field? (For example, can you cite any non-classroom evidence of your intellectual interests? Have you read extensively in specific areas of your field, attended seminars, gone to professional meetings, participated in pre-professional student groups, or held research positions?)

Briefly describe your extra-curricular interests, activities, special skills, talents and/or any significant accomplishments.

Tell of at least one person who has strongly influenced your life or career goals?