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Brandeis University
Applicant Recommendation Form
Academic year applying to ____________

To be completed by applicant

Applicant Name
Last First Middle

Program to which I amapplying: Concentration (if applicable): Federal law mandates that all admissions materials be available to the applicant for review if requested upon enrollment, unless applicant voluntarily waives theright to access. Check one: I waive I do not waive my right to read this letter

Applicant Signature


To be completed by recommender

The above named person is applying foradmission to the Heller School for Social Policy and Management at Brandeis University. Students must be capable of intensive, intellectually demanding work. Recommender Name (please print) PositionOrganization Email Phone Number

To be completed by recommender

Please rate the applicant in the following categories: Intellectual ability Breadth of general knowledge Ability toexpress self orally Ability to express in writing Ability to work with others Emotional maturity Imagination and creativity Professional effectiveness English language proficiency

Top 5%

Top 5-10%Top 10-25%


Below Average

No Basis For Judgment


Please attach a letter on official letterhead explaining how long and in what capacity you have known the applicant,and evaluate the applicant’s strengths as well as limitations. State why you would recommend the applicant, citing professional / academic performance, demonstrated leadership skills and potential tocontribute to a diverse intellectual community.

Recommender Signature Return this recommendation form to:
Office of Admissions andRecruitment The Heller School for Social Policy and Management Brandeis University 415 South Street, MS 035 Waltham, Massachusetts 02454 USA

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