Pre-Health Professions Advisement Office
Request For Supporting Documentation
Letters of Recommendation
Please provide the full name, title, address (on-campus or off-campus), and email for all individuals from whom you will
be soliciting letters of reference. For faculty please add the name and number of the course taken as well as term.
Please email this completed form to Dr. Bahamonde: matthew.bahamonde@farmingdale.edu
Before listing anyone please make sure that they have agreed to write you a letter of recommendation.
Letters should come from a cross-section of individuals, including science and non-science faculty, employers, health care
practictioners, research/internship supervisors or others able to provide evidence regarding your character.
All letters must be written on professional letterhead and include a signature. Please instuct your letter writers to send
their finished letters to Dr. Bahamonde either electronically (matthew.bahamonde@farmingdale.edu) or via US Mail
(2350 Broadhollow Rd. Farmingdale, NY 11735)
1) NAME/TITLE: _____________________________________________________________________________________
ADDRESS/EMAIL: _____________________________________________________________________________________
COURSE/TERM: _____________________________________________________________________________________
2) NAME/TITLE: _____________________________________________________________________________________
ADDRESS/EMAIL: _____________________________________________________________________________________
COURSE/TERM: _____________________________________________________________________________________
3) NAME/TITLE: _____________________________________________________________________________________
ADDRESS/EMAIL: _____________________________________________________________________________________
COURSE/TERM: _____________________________________________________________________________________
4) NAME/TITLE: _____________________________________________________________________________________
ADDRESS/EMAIL: _____________________________________________________________________________________
COURSE/TERM: _____________________________________________________________________________________
5) NAME/TITLE: _____________________________________________________________________________________
ADDRESS/EMAIL: _____________________________________________________________________________________
COURSE/TERM: _____________________________________________________________________________________