The mission of the Professional Counseling and Supervision Program is to
prepare School and Community Counselors to be exemplary leaders in
professional counseling and supervision and in program evaluation. In
addition, they will demonstrate a commitment to helping marginalized and
underserved populations in the communities, schools and agencies they
As you complete this form, we ask that you keep the mission of the program in mind:
University of West Georgia
Ed.D. in Professional Counseling & Supervision
Letter of Recommendation Form
Section 1: This section is to be completed by the applicant.
SSN or UWG ID________/________/________ Name of Applicant:_____________________________________________
Under the provisions of the Family Educational Rights and Privacy Act of 1974 (Public Law 93-380), you may decide whether letters of
reference written at your request are to be held confidential, or whether they are to be available for your personal inspec
tion. Check one
of the following statements and place your signature in the space provided so that the individual completing this form and th
e Graduate
School will be advised of your choice.
_____ Confidential. I waive my right of personal access to this reference and grant permission for this letter of recommendation to be
held confidential by the University of West Georgia.
_____ Open File. I retain the choice of having letters of recommendation available to me.
Signature of Applicant: __________________________________________________ Date: _________________________________
Section 2: Knowledge of the Applicant.
This section is to be completed by the person making the recommendation.
You have been asked to recommend the above person for admission into the Ed.D. program in Professional Counseling &
Supervision
at the University of West Georgia. We would greatly appreciate your completing this form at your earliest
convenience because we cannot consider the person's application without it. Upon request, the applicant may review this
form unless the above waiver has been signed.
1. How long have you known the applicant? ______ years ______ months
2. How well do you feel you know the applicant professionally? ˜ ˜ ˜
3. What is the nature of your relationship with the applicant? __________________________________________________
___________________________________________________________________________________________________
___________________________________________________________________________________________________
___________________________________________________________________________________________________
Return completed
recommendation form with the
complete application packet to:
University of West Georgia
Please duplicate as needed.
