Student Recommendation Form
Dr. Dave Carkenord

If you would like me to write you a letter of recommendation:
1.  Contact me (phone, email, in-person) to let me know of your need for a letter.  
2. Complete and submit this online form.

Your Name:  

Your complete email address:

Your Phone Number:

Today's Date:   (Please use 01/05/2001 format)

Is this recommendation for:  

Your Overall Longwood Grade Point Average:

Your Major Grade Point Average:

Please list all courses you have taken from me and the grades received:


Please list all extracurricular activities you have been involved with at Longwood (e.g., greek organization, student government)


Please list any other activities you have been involved in while at Longwood (e.g., work, volunteering, etc.):


Please use this space to provide any additional information you would like me to be aware of:

Date by which you need this letter:  (Please use 01/05/2001 format)

What should I do with the letter once it is completed?  (If I am to mail it directly to an employer or graduate school, please include the name/address.)