To the applicant:
The Family Rights and Privacy Act of 1974 provides that certain educational records may be open to students at their request.
The Act also provides that in the case of recommendations, the institution may request, but not require, the student to waive
his/her rights to read this confidential recommendation. Please indicate below whether or not you will waive your right to
read the confidential recommendation on this form and sign your name.
To send this form electronically, complete the section below and save the file. It may then be sent to the person completing the reference.
I do______ I do not ______ waive my right to read this confidential recommendation.
Applicant's Name _______________________________ Signature ____________________________________________
Address ____________________________________________________________________________________________
To the person completing this reference:
This applicant has applied for admission to Concordia University, St. Paul, Minnesota. In order that we may better
understand the particular qualifications, abilities, and character of the applicant, we are asking you to supply the information
requested below. We appreciate your help in properly guiding this person.
Please mail to: Director of Admissions Or digitally save and email to:
Concordia University, St. Paul
275 Syndicate Street North
St. Paul, MN 55104-5494
1. How long have you known the applicant?
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2. What are the duties and responsibilities of the TA/EA?
3. Please describe the applicant, paying special attention to character, conduct, scholarship, achievement, leadership,
cooperativeness, personality, and other information you think might be helpful to us.
4. Do you consider the applicant able to carry college work successfully
5. What particular strengths would this individual bring to the teaching profession?
6. How well does the applicant get along with people?
Date _______________________ Signature ________________________________________________________________
Position ___________________________ School ___________________________________________________________
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