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TO BE COMPLETED BY APPLICANT:
Name (Printed): ________________________________________________________
Please choose one of the options below. If neither is checked, the form will be assumed not confidential.
□ The contents of this statement are to remain CONFIDENTIAL. I waive my right to review this recommendation.
□ The contents of this statement are NOT CONFIDENTIAL. I reserve the right to review this recommendation.
Applicant’s Signature: _____________________________________________________ Date: ______________________________
TO BE COMPLETED BY RECOMMENDER:
We appreciate your answering the questions below in a specific, detailed and candid manner, noting in particular,
incidents which illustrate the candidate’s maturity, intellectual capacity and initiative.
1. Under what circumstances and for how long have you known the applicant?
2. What do you consider the applicant’s most outstanding talents or characteristics?
3. What skills do you hope the applicant will gain or improve through this program?
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