Recommendation Request Form

Recommendation Request Form

Permission To Release Education Record Information
Directions:
1. Complete the following information and click "Submit" at the end of the form.
2. Sign the form that appears on your screen by typing your full and today's date. (A copy will also be sent to your e-mail if you need to print it later.)
3. The form will be emailed to the faculty or staff member you are asking to do a reference for you.
4. Please complete one form for each reference.
Student's Name*

First NameLast Name
Student's I.D.*
Student E-mail*
Cell Phone Number

Area CodePhone Number
Class Year*
Company/School/Individual you want the recommendation addressed to*
Recipient Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Recipient Phone Number

Area CodePhone Number
Recipient E-mail
The following Stonehill College faculty/staff member has my permission to write a letter of recommendation or give a verbal recommendation on my behalf.*
Please provide the email address of the Stonehill College faculty/staff member listed above.*
ex: name@stonehill.edu
The above Stonehill Faculty/staff member has my permission to include the following information in the recommendation.*

Grade(s) earned in his/her classGPA (major or overall)Class RankNone of the Above
Right to Review the recommendation at any time in the future*

I waive my right to review a copy of this recommendation.I do not waive my right to review a copy of this recommendation.
In accordance with the Family Educational Right to Privacy Act of 1974 (FERPA), the following is considered directory information at Stonehill College and may be made available to the general public unless the student notifies the Registrar’s Office in person or in writing to the contrary.

Student’s name, address, phone number, e-mail address, date and place of birth, current enrollment, class standing (eg. senior, junior...etc - NOT rank), full-time or part-time status, schedule of classes, photograph, major and minor field of study, dates of attendance, degrees and awards received (including Dean’s List and Graduation honors), most recent previous educational institution attended, participation in officially recognized activities and sports and the weight and height of members of athletic teams.

I understand that by signing this authorization, I am waiving my rights of non-disclosure of these records under federal law only as to the person specifically listed above.
Please sign this form by typing your full name.*
Please type in today's date.*
Should be Empty: