306 LIBERTY VIEW LANE, LYNCHBURG, VA. 24502 | LIBERTY.EDU/LUCOM | LUCOM@LIBERTY.EDU

Request for Letter of Recommendation – VSASDate . : __________________________________________________________________________________(TO) Letter Writer . : ________________________________________________________________________(FROM) Student/Applicant Name . : ___________________________________________________________Student AAMC ID . : ________________________________________________________________________

TThank you for agreeing to write a letter of recommendation in support of my Visiting Student Application Service (VSAS).

This cover sheet explains the process of preparing a letter of recomendation for the VSAS application service.

1. Please address the letter as follows (individualized salutations are not necessary): VSAS - "Dear Elective Director"

2. Please include in your letter whether or not I have waived my right to see this recommendation, as indicated below.

3. Please include my name and AAMC ID, as listed above, in the subject line or body of the letter.

4. Please include in the letter of recommendation how long you have known me and in what capacity; your perceptions of my intellectual capability, communication skills (oral and writing), the quality of previous work (my ability to apply learned skills and to what level of competency), my reliability, resourcefulness, motivation, initiative and assertiveness, and my professional promise.

5. Please print on professional letterhead and attach this cover sheet to the recommendation before mailing/faxing or emailing as an attachment to the designated VSAS Dean’s Office as indicated below.

Liberty University College of Osteopathic MedicineOffice of Clinical Rotations306 Liberty View LaneLynchburg, VA 24502Fax: (434) 582-3905

Email: Email: LUCOMClinicalEducation@Liberty.edu______________________________________________________________________________________________

I waive my rights to see this letter I DO NOT waive my rights to see this letter I grant permission for the use and disclosure of my grades, academic standing and/or other academic assessments for this recommendation letter. If "waive" is checked, I waive my right to see this letter under the "Family Educational Rights and Privacy Act (FERPA)." I acknowledge that this letter is for the specic purpose of supporting my application for either a visiting elective and/or residency.

Applicant Signature: _____________________________________________________________________ Date: _________________________________________________________________________________