Lipscomb University Office of Admissions 
3901 Granny White Pike  
Nashville, TN 37204-3951 
800-333-4358 * 615-269-1776 * FAX 615-269-1804		 EDUCATIONAL 
RECOMMENDATION
This form does not become a part of the applicant's permanent file.  It will be destroyed as soon as an admission decision is made.
INSTRUCTIONS TO APPLICANT 
Complete the upper portion of this form; then give the form and a return envelope to your high school guidance counselor.
I, ______________________, am applying for admission to Lipscomb University.  I request that you send a transcript to the University and that you supply the information requested.  Return the completed form to the University.

Applicant Signature ________________________________________ Date ___________________________
Address ____________________________________________ Phone # (     ) ___________________________
City ____________________________________________ State _________ Zip _____________-______________ 

INSTRUCTIONS TO REFERENCE 
Lipscomb University is a private, church-related, liberal arts university, emphasizing Christian character and high academic standards.  Thank you for your assistance in our consideration of this student.  Please notice that the applicant requests that you send a transcript as well as a  reference.
Check one:  ___ I am well acquainted with the applicant 
___ I am moderately acquainted with the applicant 
___ I do not know the applicant personally
Please provide the following data: GPA _____ (4.0 scale).     Class rank: #____ in a class of ____
If grades on the transcript are recorded numerically, please give the letter conversion.
 
A = ____ to  ____  C = ____ to  ____ 
B = ____ to  ____  D = ____ to  ____ 
  1. Has the applicant ever been suspended or dismissed from school for any reason?

    2. ___ No ___ Do not know ___ Yes  (please explain) _________________________________________________
    ____________________________________________________________________________________________
  2. Do you have any doubts about the applicant's ability to graduate from college?

    3. ___No ___Yes (Please explain) _________________________________________________________________________
    ____________________________________________________________________________________________
  3. Does the applicant have any personal habits/attitudes that you feel are inconsistent with attendance at a Christian university? ___ No ___ Do not know ___ Yes  (please explain) _________________________________________________
    ____________________________________________________________________________________________
    ____________________________________________________________________________________________
  4. Provide general observations about the applicant's personal qualities, such as leadership potential, peer relationships, integrity, etc. _________________________________________________________

    5. ____________________________________________________________________________________________
Check one:  ___ Recommended for admission 
___ Make no recommendation		 ___ Do not recommend 
___ Contact me for further information

Signed __________________________________________ Occupation _____________________________
Mailing Address ________________________________________________________________________________
School Telephone (      ) ______-___________ High School ______________________________________________