On-line Letter of Recommendation Form
Student's
L
ast
Name:
Student's
First
Name:
Student's School:
Your relationship to the student:
-Select-
Instructor
Academic Advisor
Research Advisor
Faculty Advisor to Chemistry Club
Other
If 'other' selected, please specify:
Evaluation of student (1=Excellent to 5=Poor):
Chemical knowledge for college level study:
-Select-
1
2
3
4
5
No basis to judge
Maturity:
-Select-
1
2
3
4
5
No basis to judge
Laboratory skills:
-Select-
1
2
3
4
5
No basis to judge
Work habits:
-Select-
1
2
3
4
5
No basis to judge
Creativity:
-Select
1
2
3
4
5
No basis to judge
Ability to follow directions:
-Select-
1
2
3
4
5
No basis to judge
Ability to work with others:
-Select-
1
2
3
4
5
No basis to judge
Overall ability to perform research:
-Select-
1
2
3
4
5
No basis to judge
Scientific curiosity:
-Select-
1
2
3
4
5
No basis to judge
Other comments
:
Recommender Information:
Your title:
-Select-
Prof.
Dr.
Mr.
Mrs.
Ms.
Your full name:
Your full mailing address:
Your phone number (incl. area code):
Your e-mail address:
Please re-enter your e-mail
above address to confirm:
Thank you!