MIDDLEBURY COLLEGE
EDUCATION STUDIES PROGRAM
ACADEMIC REFERENCE
To the Applicant: Fill in your name, major, and complete the waiver form. Fill in the professor's name and
personally take this form to the professor.
Name: _______________________
Major: _________________
Under Section 438, General Education Provisions Act (Public Law 90-247), you have the right to review
materials submitted in connection with your application. This law also allows you to waive this right if you
so choose, understanding that confidential recommendations are not required in the admissions process.
Please check one and sign:
I do not waive my right of access to this information
I do waive my right of access to this information
Signed: ________________________________________
Professor being asked to complete this form: ________________________
Department: _______________________
The Professional Semester in Education Studies is a semester-long, full-time practicum at a local school,
leading to recommendation for teacher licensure.
To succeed, the applicant must have a broad understanding of the liberal arts and substantive knowledge of the
subject matter, and possess the analytical and research skills to master new materials. Because student teachers
are involved in a challenging role working with children or adolescents, they must have a high degree of
commitment and the ability to adjust to people of different social and cultural backgrounds. We cannot overemphasize the value of your candid appraisal in enabling us to determine if the applicant is prepared for this
pre-professional program. You may complete this form or write a letter of evaluation.
The candidate's application cannot be reviewed until we receive this form. Please return it promptly to
Trish Dougherty, Twilight Hall, no later than March 15.
Please rate the applicant on the following characteristics:
Outstanding
Satisfactory
Poor
Unknown
Knowledge of subject matter
a. Facts and concepts
b. Research
c. For foreign languages only
Proficiency in the language
Writing ability
Oral ability
Initiative and follow-through
Revised 2/13
In what capacity and for how long, have you known this student?
Type here or attach sheets
What are this student's intellectual strengths and weaknesses relevant to teaching?
Type here or attach sheets
In your opinion does this student have a clear motivation for teaching and does she/he have the ability and
potential to become a competent teacher?
Type here or attach sheets
Please add any other comments (use other side) which would help the Education Studies Committee in its
decision.
Type here or attach sheets
___________________________________________________
Signature
Date
_________________
Department/Program
Revised 2/13