Department of Mathematics & Statistics
California State University, Chico
Letter of Recommendation Access Waiver Form
The Family Educational Rights and Privacy Act of 1974 (FERPA) (20 U.S.C. 1232g) and the regulations adopted thereunder (34
C.F.R. 99) gi
ves applicants the right to inspect letters of recommendation written in support of applications for admission,
employment, or awards. The law also permits students to waive that right if they choose, although such a waiver is voluntary and
cannot be a condition of admission, employment, or award.
APPLICANT / STUDENT
This section is to be completed by the Applicant prior to submitting form to the Recommender. Letters of recommendation
will not be accepted unless accompanied by this form. Letters and forms are to be mailed directly by your recommender to
the department address below. Please include a self-addressed stamped envelope. Address to: Dept. of Mathematics & Statistics,
CSU, Chico, 400 West First Street, Chico, CA 95929-0525. *Note: International applicants may send sealed recommendations with
their application material directly to the Office of International Education.
Applicant Name:
I waive my right of access to this form and letter of recommendation.
I do NOT waive my right of access to this form and letter of recommendation.
Signature Date
RECOMMENDER
Name (please print or type) Institution or Company Name
Title / Position Relationship to Applicant (advisor, supervisor, etc.)
Please rate, by checking the appropriate boxes, the applicant relative to other students with whom you have worked who have gone on
to graduate school in recent years:
On a separate sheet of letterhead, please write candidly about your knowledge of the applicant and the applicant’s qualifications,
including but not limited to the applicant’s discipline, creativity, intellectual independence, capacity for critical thinking, and ability to
organize and express ideas clearly, especially as these qualifications relate to the field of teaching.
Please sign this form below, thus indicating your awareness of the applicant’s choice regarding right of access to your letter of
recommendation, staple it to your signed letter of recommendation printed on letterhead, and mail in the envelope provided to you by
the applicant (see above).
Should you have questions, please contact the Dept. of Mathematics & Statistics at 530-898-3487 or pmorrell@csuchico.edu.
Thank you for your support and cooperation.
