PO Box 6000
Binghamton, NY 13902
Fleishman Center for Career & Professional Development
Johnson City Middle School Mentoring Program
RECOMMENDATION FORM
Instructions: Recommendation must be from faculty, employer, or University staff (ex. Academic Advisor).
Completed form should be sent via email to jcmentor@binghamton.edu or be sent in a sealed envelope with signature
of reference across seal to the Fleishman Center (UU 133), Attention: Ms. Lexie Avery, Career Consulting Assistant.
Form must be submitted by the application deadline.
STUDENT INFORMATION
Name
__________________________________ B #
_________________
REFERENCE
Name
Email
__________________________________ Title
__________________________________ Phone #
How do you know student?
_________________
_________________
_________________ How long have you known student?
The Johnson City Mentor Program provides Binghamton University undergraduate students the opportunity to mentor a
Johnson City Middle School student for academic credit. Selected students are matched with mentees for the semester.
The experience allows students to make a difference through mentoring, explore school careers, develop writing skills in
the writing intensive seminar and diffuse issues such as bullying while building interpersonal skills through a mentoring
relationship.
It is crucial that the students selected represent the high caliber of students who attend Binghamton University. Your input
is essential for the selection process.
Would you recommend this applicant as a student who would represent Binghamton University well?
Yes ☐
No ☐
Would you recommend this applicant to mentor a Johnson City Middle School student?
Yes ☐
No ☐
Please rate the student in each category based upon the following criteria:
1 – Unsatisfactory (Does not meet expectations), 2 – Fair (Rarely meets expectations), 3 – Good (Consistently meets
expectations), 4 – Very Good (Sometimes exceeds expectations), 5 – Exceptional (Consistently exceeds expectations)
Listening and Oral Communication Skills
Listens to others in an active and attentive manner
Demonstrates effective verbal communication skills
Professional and Career Development Skills
Exhibits professional behavior and attitude
Exhibits a positive attitude
Overall Assessment out of 20 possible points
Rating
Additional Comments/Concerns (optional):