OFFICE OF ADMISSIONS
RECOMMENDATION FORM Florida Southern College
All full-time applicants to Florida Southern College are required to submit a minimum 111 Lake Hollingsworth Drive
of one academic recommendation. This form has been provided as a guide. However,
Lakeland, Florida 33801-5698
if it is more convenient, please feel free to submit a type-written letter.
(863) 680-4131 • Fax (863) 680-4120
Name of Applicant ________________________________________ Social Security Number: __________________
Address: ______________________________________________________________________________________
TO THE STUDENT
City/State/Zip: __________________________________________________ Telephone (______________________
)
Name of Reference _______________________________________ Title/Position: __________________________
Address: ______________________________________________________________________________________
City/State/Zip: __________________________________________________ Telephone (______________________
)
To be completed by applicant:
I hereby grant permission for the release of the information requested on this form to the Office of Admissions,
Florida Southern College (signed) __________________________________________________________________
I hereby waive all rights of access to the information contained on this form and understand that it will be kept confi-
dential between the referee and Florida Southern College (signed) ________________________________________
Dear Reference:
Thank you very much for taking your time to evaluate this candidate’s qualifications for admission to Florida
Southern College. Your recommendation will become a part of his/her admissions file.
You may use this original form or write a personal letter; however, it is not official unless it is mailed to the Office
of Admissions.
1. Your contact with this candidate is/was as a _____ teacher _____ counselor _____ employer _____ coach
_____ other (please describe)________________________
TO THE REFERENCE
2. Have known candidate for _______ yrs. I know him/her _____ well _____ fairly well _____ slightly
3. Please check the degree to which this candidate demonstrates the following qualities:
Above Below Do Not
Excellent Average Average Average Know
A. academic ability
B. academic motivation
C. written expression
D. oral expression
E. energy and initiative
F. independence
G. originality
H. leadership
I. self-confidence
J. warmth of personality
K. sense of humor
L. concern for others
M. reaction to criticism
N. social-emotional maturity
O. adaptability
P. judgment
Q. responsibility
PLEASE COMPLETE BOTH SIDES OF RECOMMENDATION FORM
3. Is candidate respected by his/her peers? ________.
The main factors contributing to that respect seem to be:
( ) Superiority in studies ( ) Success in athletics
( ) Leadership in activities ( ) Accomplishment in activities
( ) Interest in other students ( ) Personality
The main factors contributing to a lack of respect seem to be:
( ) Superiority in studies ( ) Conceit
( ) Lack of interest in other people ( ) Not well known
( ) Manners, personal habits ( ) Other (specify) _______________
4. Do you have unqualified confidence in this candidate’s integrity? ____
If your confidence is qualified in any way, please explain ___________________________________
TO THE REFERENCE
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
5. General comments regarding candidate’s strengths: __________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
6. Comments regarding areas that need improvement: __________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
7. Additional Comments: __________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
Reference’s Signature _______________________________________________________ Date ________________
Thank you for your time and effort. Please mail to the Office of Admissions at the address below:
Office of Admissions
Florida Southern College
111 Lake Hollingsworth Drive
Lakeland, Florida 33801-5698
Toll-Free: 1-800-274-4131
Office: (863) 680-4131 • Fax: (863) 680-4120
