Sample International REU Site Program Refernce Request Form

U.S.-[FOREIGN SITE] Research Experience for Undergraduates (REU)
Department of ABC
XYZ University

Sample Reference Request Form POSTMARK DEADLINE FOR SUBMISSION: MM/DD/YYYY

Applicant Name _______________________________________________________

The Family Educational Rights and Privacy Act (FERPA; 34 C.F.R. Part 99) provides rights and protections regarding the disclosure of records held by educational institutions. These rights and protections apply to documents, files and materials in whatever medium, which contain information related directly to a student and from which a student can be individually identified. By signing the waiver statement below, I waive my right to inspect under FERPA the reference letter solicited herewith. This waiver applies to all future holders of the solicited letter.

£ I waive my right of access to this reference letter.

_________________________________________________

(Applicant signature and date)

OR

£ I do not waive my right of access to this reference letter. (If waiver statement is unsigned, the student is specifically reserved the right of access to this reference letter.)

_________________________________________________

(Applicant signature and date)

Recommender Instructions:

1. Please read and complete this reference request form, supplying the information requested below. If you wish to use your own institutional stationery, please attach this completed form to your letter.
2. Please sign and date the reference report where indicated.
3. Please transmit completed form, together with your reference report:
   U.S.-[FOREIGN SITE] REU Program Department of ABC XYZ University City, State ZIP

   BY MAIL TO:	OR, FAX TO:
   (###) ###-####
   OR, E-MAIL TO:
   abc@xyz-univ.edu

4. The postmark deadline for submission of all materials is November 30, 200X.

[For U.S.-[FOREIGN SITE] REU program information, consult the Web site at: http://…]

Reference Report

Recommender’s Name	_________________________________________
Department	_________________________________________
Institution	_________________________________________
Address	_________________________________________
	_________________________________________
Telephone	____________________________
Fax	____________________________
E-mail	____________________________

How long, and in what capacity, have you known the applicant?





In specific terms, explain how participation in the U.S-[FOREIGN SITE] REU Program will benefit the applicant in pursuit of his/her academic and professional careers. What unique approaches, opportunities, or skills will the applicant obtain through program participation?



Describe the applicant’s potential for academic and professional achievement. Specifically, please comment on the applicant’s readiness to conduct scholarly research at an international site under this REU program.




I rank this applicant in the top ______ % of undergraduate students I have known.

Please check one of the two statements below. (The U.S.-[FOREIGN SITE] REU program will honor your request to the extent permitted by law.)
£ My identity and this report must be held in confidence.
£ This report may be released to the applicant upon his/her request.

Recommender’s Signature _______________________________________
Date _________________________

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Last updated April, 2002 by Joan Marler