Summer Programs Academic Reference Form

This form is Confidential. To aid in the assessment of the below student’s potential for a successful adjustment to a program of study away, we would appreciate your completing this academic reference form. Thank you for your cooperation.
  • Name of the student

    If the student has previously submitted the program application form, he/she has waived his/her right of access to this recommendation under the provision of the Family Educational Rights and Privacy Act of 1974. However, if you are submitting this recommendation before the student has submitted the application form, access has NOT YET been waived.

  • Please enter the student’s email address. The student will receive notification when the academic reference has been submitted. The actual details of the academic reference will not be shared, just an automatic notification stating that the reference was received.
    If you’re unsure, you may indicate that above, however, it may be a good idea to check with the student to ensure the academic reference is submitted to the correct department. Some students will choose to apply to more than one SMC Study Away Summer program. In that case, please select the program from the above selections with the earliest application deadline.
  • Please rate this student according to the following

  • Eg. (215)555-5555