FULBRIGHT PROGRAM
APPLICATION FOR STUDY IN THE UNITED STATES
CONFIDENTIAL LETTER OF REFERENCE
This letter of reference must be written by a teacher under whom the applicant has studied or pursued research in the proposed field of study
or by someone who has supervised the applicant in work related to the proposed field of study. This letter must be typewritten and in English.
If not in English, then an accurate translation must be attached. Use the TAB key to move between fields.
NAME OF APPLICANT COUNTRY
NAME OF REFEREE
TITLE
ADDRESS CITY
COUNTRY POSTAL CODE
PHONE NUMBER E-MAIL ADDRESS
HOW LONG HAVE YOU KNOWN THE APPLICANT?
IN WHAT CAPACITY HAVE YOU
KNOWN THE APPLICANT?
Teacher or Professor
Employer or
Job Supervisor
Research Adviser
Other (Please Specify
3. IN THIS RATING CHART, PLEASE EVALUATE THE APPLICANT IN COMPARISON WITH OTHER STUDENTS WHOM YOU HAVE KNOWN
DURING YOUR POFESSIONAL CAREER.
Excellent Very Good Average Below Average Not Applicable
Intellectual Ability
Knowledge of Field
Work Habits
Motivation to Pursue Graduate Study
Seriousness of Purpose
Potential For Significant Future Contribution in Field
Resourcefulness and Initiative
Emotional Maturity
Adaptability to New Situations
Leadership Qualities
Teaching Potential
NAME OF APPLICANT COUNTRY
INSTITUTION OR BUSINESS
Confidential Letter of Reference Page 1
CONFIDENTIAL LETTER OF REFERENCE (Continued)
3. PLEASE PROVIDE A CANDID EVALUATION OF THE APPLICANT’S PAST PERFORMANCE AND ABILITY TO PURSUE AND
SUCCESSFULLY COMPLETE A PROGRAM OF STUDY IN THE PROPOSED FIELD. YOUR INFORMATION WILL BE GIVEN CONSIDERABLE
IMPORTANCE IN REVIEWING THIS APPLICATION.
NAME (Print)
SIGNATURE DATE
PLEASE RETURN DIRECTLY TO FULBRIGHT PROGRAM OFFICE.
NOTE: The Fulbright Program cannot guarantee this letter’s confidentiality once it becomes part of a university’s records.
Confidential Letter Reference Page 2