Clark University

Office of Study Abroad Programs

Confidential Academic Reference Form

To be completed by the applicant:

Name
Study Abroad Program
Graduation Year / Major(s)

I hereby waive my right to access the information on this completed form:

Applicant
Signature / Date

To the referee:

The above-named student is applying for admission to a Clark-Affiliated study abroad program. For Clark approval to study abroad it is required that the student obtain a faculty recommendation. Any information you can provide in evaluating the candidate's suitability for study abroad participation will be helpful. We ask you to consider the applicant's academic qualifications and, insofar as you are able, to assess his/her personal qualifications as well (strengths and weaknesses, sense of responsibility, emotional stability, motivation, character, and ability to live and work with others.) All information will be considered confidential.

Scan and email the completed form to , or return to Study Abroad Dana Commons via campus mail.

Please note that this recommendation is for Clark University approval only. The student will apply independently directly to the program and may ask you to write an additional recommendation for the specific program. Please consider saving a copy of your comments for future reference.

How long have you known the applicant?
In what capacity?

In terms of intellectual qualities and capabilities, how would you rate this applicant compared with other students you are teaching?

In the top 5% / In the top 10%
In the top 20% / In the top 25%
Other:

How would you describe the applicant's academic progress since the start of his/her university career?

Steadily Improving: / Erratic:
Constant: / Deteriorating:

Please report student's strengths and weaknesses, as well as any aspect of the applicant's character or personality that might affect his /her success on a study abroad program.

How would you recommend this candidate?

Enthusiastically / Favorably / With Reservations

Please write additional comments on University Department stationery.

Name of Referee (print):
Position:
Signature: / Date:

Academic Reference Form.docx

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