Reference Report

Michigan State University
School of Labor and Industrial Relations

Mail this form to:
Ph.D. Program Committee
School of Labor and Industrial Relations
401 South Kedzie Hall
Michigan State University
East Lansing, MI 48824-1032

Name of applicant

Current Address

Authorization for Waiver: To be read and signed by the applicant:

This waiver is not required as a condition of admission to Michigan State University for Graduate Study.

I understand my right under the U.S. Family Rights and Privacy Act of 1974 to review confidential appraisals placed in my file on or after January 1, 1975 that are submitted with reference to admission to a graduate or other school.

I do___ do not___ waive my right to review this reference report.

Date_________________________
Signature of Applicant____________________________________________

To the applicant:
Complete the above information and send this form to the individual who will be providing your reference.

To the evaluator:
The individual listed above has asked you to serve as a reference for his/her application to the School of Labor and Industrial Relations graduate program. Please complete the information requested below and attach your letter of evaluation. Please put your letter on official university or business letterhead and return your letter and this form to the above address. Your candid evaluation of the applicant is appreciated.

Name of Evaluator

How long and in what capacity have you known the applicant?