Graduate Admissions Office

Goodell Building, University of Massachusetts Amherst, 140 Hicks Way, Amherst, MA 01003-9333
Recommendation Form
APPLICANT: Print one form for each referee. Fill in top of page, then give to referee. Your name should be listed here as it appears on your application
form. If your referee chooses to use another type of recommendation form, attach this page as a cover page.
Date:_______________________ Applicant's Date of Birth: ______________________________
Name of Applicant: Last______________________________________________ First ____________________________ Middle ____________
Proposed Graduate Program:__________________________________________________________ Sub-field:___________________________________
Under the provisions of the Family Educational Rights & Privacy Act of 1974, I waive my right of access to this letter of recommendation. The University
of Massachusetts may consider it confidential.
_____________________________________________________________________________________ ( Optional )
Signature of Applicant

If student has signed above waiver, we assure the referee that this form will be held in strictest confidence. Please comment on the applicant's character and
ability to carry out advanced graduate study and research. Compare the applicant to others you have known in this field. If you prefer, you may write a
separate letter and attach it to this form.

I would rank this student in the top ______ % of approximately ______ students I have taught in _____ years.

Upper Upper 10% But Not Upper 25% But No Basis for
CHARACTERISTIC Upper Half Lower Half Judgement
1 or 2 % Upper 1 or2% Not Upper 10%
Breadth of General Knowledge
Ability in Oral Expression

Ability in Written Expression

Perseverance

Emotional Maturity

Imagination & Probable Creativity

Potential as a Teacher

Signature _______________________________________________________________________________________________________________
Name (print) _____________________________________________________________________________ Date _________________________
Institution ________________________________________________________Position/Title ______________________________________
Address ____________________________________________________________________________________________ Zip ________________