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Template For Reference Letter

Template for Letter of Recommendation
Student fills in information in black.
OSA fills in information in gray.
Information in red is fixed, do not delete or edit.
After completing the information below, save a copy of the template and attach it to the email
message to osahelp@uic.edu. Make sure to include the Student Request Form (SRF).
______________________________________________________________________
[Date]
[Full Name of Addressee]
[Name of Organization]
[Street Address]
[Additional Address Info.]
[City, State Zip Code]
Re: [Student’s Full Name], Letter of Recommendation for
[Name of What Letter is For – e.g., scholarship, fellowship, research, etc.]
Dear [Name of Addressee (e.g. Scholarship/Selection Committee) – if person,
Dr./Senator/Representative/Mr./Ms., etc. + Last Name]:
I am pleased to write aletter of recommendation for [Mr./Ms.] [Student’s Full Name] who is applying for
the [Name of What Letter is For]. [Student’s First Name] is a [first, second, third, fourth] year medical
student who received [his/her] [B.A., B.S., other-Student fills in] degree in [major/major with a minor in-
Student fills in] from [Name of Undergraduate Institution-need to include "the" if appropriate], where
[he/she] graduated with [honors-if applicable; a GPA of –if applicable]. [Student’s First Name] was
[Student fills in any undergraduate honors, awards, honor societies, scholarships, etc. and whether
received, selected, inducted, or awarded]. [Student’s First Name] was actively involved in[fill in any
extracurricular activities with leadership positions held, community service, etc.]. [Student’s First Name]
performed research in the lab of Dr. [Full Name of Research Advisor] in the Department of [Name of
Department] at [Name of Institution]. [Student fills in brief description of student’s responsibilities for the
research and/or brief description of the research]. The research resulted in [number-fill in] [publication(s)/
poster presentation(s)/ abstract(s)/ other-Student fills in]. [Student fills in any other additional research
experiences with same information above for each experience].
(OPTIONAL SECTION; ONLY IF APPLICABLE) Prior to medical school, [Student’s First Name] [Student
fills in any other degrees with all of the same information detailed above and/or Student fills in any work
experiences, etc. did between college and medical school and /or Transfer Student fills in where began
medical school, dates (years) of attendance, any honors, awards, scholarships, extracurricular/leadership
activities, research, etc. in same format as detailed above].
[Student’s First Name] entered the University of Illinois College of Medicine at Chicago (UIC COM) in
[month] of [year] and has distinguished [himself/herself] asa [OSA fills in]. [He/She] has been [Student
fills in any medical school honors, awards, A A, ISP, scholarships, etc. and whether received, selected,
inducted, or awarded]. [Student’s First Name] has demonstratedinitiative and leadership skills through
[his/her] involvement in [Student fills in any extracurricular activities with leadership positions held, brief
description of leadership activities and outcomes, etc.].
[Student’s First Name] has also demonstratedcommitment to community service as well as public and
civic affairs through [his/her] volunteer work. [He/She] has been actively involved in [Student fills in
volunteer, community service, mentoring, etc. activities].
(OPTIONAL SECTION; ONLY IF APPLICABLE) [Student’s First Name] has also demonstrated alevel of
interest in research. [He/She] has performed research in the lab of Dr. [Full Name of Research Advisor] in
the Department of [Name of Department] at [Name of Institution]. [Student fills in brief description of
student’s responsibilities for the research and/or brief description of the research]. The research resulted
in [number-fill in] [publication(s)/ poster presentation(s)/ abstract(s)/ other-Student fills in]. [Student fills in
any other additional research experiences with same information above for each experience].
In my observation of [Student’s First Name], [he/she] clearly has[OSA fills in].Therefore, I[OSA fills in]
[him/her] as [OSA fills in] candidate for the [Name of What Letter is For] and give [him/her] my full and
unqualified support.
Sincerely yours,
Kathleen J. Kashima, PhD
Senior Associate Dean for Students
cc: Dr. [Full Name of Student’s Advisor]
Student File
OSAAdvisor’s initials
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