Lipscomb University Office of Admissions 
3901 Granny White Pike  
Nashville, TN 37204-3951 
800-333-4358 * 615-269-1776 * FAX 615-269-1804		 PERSONAL 
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 a church or business leader other than family who is qualified to give an informed appraisal.
I, ______________________, am applying for admission to Lipscomb University.  I request 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. 
Check one:  ___ I am well acquainted with the applicant 
___ I am moderately acquainted with the applicant
 
  1. In what circumstances/relationships do you know the applicant? ______________________________________

    2. ____________________________________________________________________________________________
    ____________________________________________________________________________________________
  2. 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) _______________________________

    3. ____________________________________________________________________________________________
    ____________________________________________________________________________________________
    ____________________________________________________________________________________________
  3. Provide general observations about the applicant's personal qualities, such as leadership potential, peer relationships, integrity, etc. _________________________________________________________

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

Signed __________________________________________ Occupation _____________________________
Mailing Address ________________________________________________________________________________
Home Telephone (      ) ______-______________ Work Telephone (      ) ______-______________