VALMEYER HIGH SCHOOL

REQUEST FOR REFERENCE

Complete this form and give to the person writing the reference at least two weeks prior to the date the reference is needed in the guidance office.  This recommendation will be used only for the purpose indicated by you on this form.

To:_______________________   From:_______________

(Person you are requesting the reference from)

I am requesting:

____That you fill out the attached form.

____Write a letter of reference addressed to:

                             Name:____________________________

                             Address:__________________________

                             City, State, Zip:_____________________

Recommendation use: 

Job Application               School Admission            Scholarship

Special areas to mention in letter __________________________________________________________________________________________________________________

Disposition of Letter:

____Mail directly (envelope attached) by this date:__________

____Return to Mrs. Karsten by __________(5 days prior to mailing deadline)

___I waive ___I do not waive my right to inspect my recommendation prior to it being mailed.

__________________________      _____________

Student Signature                               Date

SCHOOL PERSONNEL WRITING LETTERS OF RECOMMENDATION ARE ASKED TO RETURN THIS COVER SHEET TO MRS. KARSTEN.