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.
(Person you are requesting the reference from)
I am requesting:
____That you fill out the attached form.
____Write a letter of reference addressed to:
City, State, Zip:_____________________
Job Application School Admission Scholarship
Special areas to mention in letter (Consider attaching a brief resume)
Disposition of Letter:
____Mail directly (envelope attached) by this date:__________
____Return to me 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