Letter of Recommendation Data Entry Form

This form was adapted from my colleague Dr. Dennis Sullivan (with his kind permission).

The information you provide here is meant as a guide only, and will help Dr. McClain to write a more complete letter of recommendation.  You will be notified if Dr. McClain is unable to accomodate your request.
Please include any additional information not covered here in the 'Comments' section at the end.  Submit this information as early as possible. Generally, letters are sent within a week, but during busy times of the year, it may take up to three weeks.  Note any deadline for envelope postmark in the 'Special Instructions' section.

Questions about this page? Send an E-mail to:   mcclain@cedarville.edu

Personal information:

Full Name:    Soc. Sec. #:      

Phone Number:        Email:   

Status:     Level:       GPA:  

Degree Program:        Academic Advisor:    

Exam taken:         Scores:  

How long have you known Dr. McClain?    

University Activities:

How long have you been at Cedarville University?    

Student Organizations (include offices held):

International Travel (MIS trips, study abroad, etc.):

Professionally-Related Activities (lab assisting, etc.):

Relevant Work Experience:

Service Activities (tutoring, volunteer work, etc.):

Special Honors and Awards (include scholarships):

Sports and Music Activities:


Letter Details:

Reason for letter  

Addresses for your letter:

(please leave a space between each address):

Total Number of Addresses Submitted:  

Special instructions:

Please remember that letters of recommendation are considered confidential; this information is only shared with admissions committees, academic department heads, or potential employers.  The contents of these letters are not normally made available to the students who requested them.

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Copyright © 2000 Dennis Sullivan, MD