STATE UNIVERSITY OF NEW YORK CONFIDENTIAL REFERENCE FORM
Overseas Academic Programs
Academic Reference
_
_____________________________________________________________________________________________________________________
Students Name Program Location Abroad Administering SUNY Campus
To the Student
This academic reference should be given to a professor
who knows you well and is able to judge your academic qualifications for
study abroad. A letter of recommendation on letterhead is also acceptable.
I waive my right to access this reference completed by _________________________________________________ Yes No
Name of Reference
Student's Signature:____________________________________________________________________ Date:___________________
To the Reference
T
he student named above is applying for the designated State University of New York overseas academic program. We would
appreciate your assessment of the applicant's attributes with which you are familiar. You may also attach a letter of recommendation.
How long and in what capacity have you known the student?___________________________________________________________
Academic attributes
Excellent Very Good Good Fair Poor No Evaluation
Competence in major or specialization
Acad
emic interest and motivation
Ca
pacity for independent study
Res
ourcefulness
Reliabilit
y
In
tegrity
Non-
academic attributes
Excellent Very Good Good Fair Poor No Evaluation
Level of maturity
Ab
ility to adapt to new or unstructured circumstances
Self-c
onfidence and self-esteem
Ab
ility to relate well to others
Em
otional stability
Op
en-mindedness
In
tegrity
Pleas
e state frankly your opinion of this candidate's ability to suitably represent both their home campus and the USA in a
study abroad program, weighing both strong and weak points. Please use the space below or the reverse side of this page. You
may also add or attach a letter of recommendation.
Your Name (please print)__________________________________________Title, Department:______________________________
Signature: ____________________________________Date:___________________ Institution:______________________________
To
submit this form:
This form can be scanned and emailed to studyabroad@farmingdale.edu
Faxed to 631.420.2780 or
Delivered via campus mail to Laffin Hall, 320
