RESPONSE/REBUTTAL FORM
(Complete this section before submitting to Faculty Affairs)
A copy of this form will be attached to the rebuttal submitted by the candidate and immediately delivered to
the appropriate reviewing body.
Name of Candidate Date of Submission
Program
ACTION TAKEN BY REVIEWING BODY
(This section to be completed by the reviewer(s).)
Please review the attached response/rebuttal and complete this section. (Please note that if you check "b"
below and change your recommendation, you may choose to prepare a revised letter, but a new letter is not
required.)
Check a
, b, or c and sign below:
a) I/We have reviewed the response/rebuttal to my/our letter of recommendation and conclude that the
response/rebuttal does not alter my/our recommendation.
b) I/We have reviewed the response/rebuttal and have changed my/our recommendation. My/Our new
recommendation is:
c) This response/rebuttal was received after the ten (10) day deadline date. It will be added to the
WPAF and will be considered by all subsequent levels of review.
Signature Date
Title
(NOTE: After this form has been completed by the reviewer(s), please return to Faculty Affairs.
Revised 3/2010
