Letter of Recommendation Form

Site managed by Dr. David Essig
Questions about this page? Send an E-mail to: dessig@geneva.edu

The information you provide here is meant as a guide only, and will help the faculty to write a more complete letter of recommendation. Please include any additional information not covered here in the 'comments' section at the end.

Please remember that letters of recommendation are considered confidential; this information is only shared with admissions committees, academic department heads, or potential employers. The contents of these letters are not normally made available to the students who have requested them.

The answers to your questions will be sent by E-mail, and forwarded to the appropriate individual(s).

Person to write your letter (or indicate if a committee letter is needed):

Your Full Name:
(usually required for pre-med letters)
Soc. Sec. #:
(optional, and only if specified)
Phone Number:

Current Status

Geneva Student
Geneva Alumnus
Other Student
Other Graduate

Major Area of Study

Computer Science

Current Level

Degree Expected
Bachelor of Science
Bachelor of Arts
Bachelor of Science in Nursing

Reasons for This Letter
(Choose all that apply)

Medical School Application
Veterinary School Application
Dental School Application
Physical Therapy School Application
Graduate School Application
Job Application
Other (explain later in 'Comments')

Academic Advisor:
Grade Point Average:

Exam Taken (choose one):

AHPAT (Allied Health)
DAT (Dental Admissions Test)
GRE (Graduate Record Exam)
DAT (Dental Admissions Test)
MCAT (Medical College Admissions Test)
OAT (Optometry Admissions Test)
PCAT (Pharmacy College Admissions Test)
VCAT (Veterinary College Admissions Test)

Composite Score:

How long have you been a student at Geneva College?

How long have you known the person writing your letter?

University Activities:

Student Organizations (include offices held):

International Travel (MIS trips, study abroad, etc.):

Professionally-Related Activities (observing in hospital, special study programs, etc.):

Relevant Work Experience:

Service Activities (tutoring, volunteer work, etc.):

Special Honors and Awards (include scholarships):

Sports and Music Activities:

Additional comments, suggestions, or special instructions:

Addresses for your letter:
Type "NONE" if none are included here.
Please leave a space between each address.

Total Number of Addresses Submitted:

How can we contact you? Please give your E-mail address or telephone number:

The "Send" button will send all your answers to Dr. Essig as E-mail.

Required fields: Written by, Name of Student, Reason, and Addresses.
(Be sure to type in "none" for Addresses if none are included at this time)