Applicant, please print or type the following information:
Applicant Graduate Program
Name of Evaluator
Evaluator’s Email Address
I waive my right to review or access letters and statements of recommendation written on my behalf. □ Yes □ No
Complete the following prompt and return the completed document one of the following ways: 1) email as a saved .pdf to
firstname.lastname@example.org, 2) mail a printed document to the address above, or 3) upload your document via SENDedu. All
recommendations must be signed and submitted by the recommender to be considered valid. (Please send/upload a separate
letter if you need more room to provide your recommendation.)
Please give your evaluation of the candidate’s promise for graduate study. We are interested in the candidate’s
preparation, intelligence, originality, research skills, and other pertinent qualities.
□ Excellent □ Above Average □ Average □ Below Average □ Poor
Name of Evaluator* Date
* If you are submitting this form electronically, printed name serves as your signature.
In its educational policies, programs, and procedures, the University provides equal opportunity for all its students without regard to race,
color, religion, sex, age, disability, or national or ethnic origin.
Office MSC #177
5000 North Willamette Boulevard
Portland, Oregon 97203-5798
503.943.7107 / TDD 503.943.7484