CHEYNEY UNIVERSITY
O F   P E N N S Y L V A N I A 
CHEYNEY, PENNSYLVANIA 19319
1-800-CHEYNEY
1-800-243-9639
(601) 339-2275
TEACHER
RECOMMENDATION
TO THE APPLICANT:
Complete the top portion of this form and give it to one of your teachers.
___________________________________________________________________________________________________________________________
APPLICANT'S NAME Last First Middle Maiden
___________________________________________________________________________________________________________________________
ADDRESS Street City State Zip Code
___________________________________________
SOCIAL SECURITY NUMBER (REQUIRED)
Teacher's Name __________________________________ Title ________________________________________________________________________
How long and in what context have you known the student? ______________________________________________________________________________
___________________________________________________________________________________________________________________________
What are the first words that come to you your mind to describe this student? ________________________________________________________________
___________________________________________________________________________________________________________________________
Please comment on your impressions of the student's personal qualities,
particularly in regard to character, integrity, values, and peer relationships.  ____________________________________________________________________
___________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________

Compared to other college-bound students, how would you rate this student in terms of academic skills and potential? 
No Basis 
for 
Comment		 Below 
Average		 Average Good Very 
Good		 Excellent
  Creative, original thought          
  Motivation          
  Independence, initiative          
  Intellectual ability          
  Academic achievement          
  Written expression of ideas          
  Effective class discussion          
  Disciplined work habits          
  Potential for growth          
  Character & personal promise          
  SUMMERY EVALUATION          
 
Comments: __________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________