Cover Sheet for Confidential Reference Letter
Attached is a confidential letter of reference for the sole purposes of college admission and academic counseling.
College information College or University Admissions Office address
Application deadline Applicant information Name Soc. Sec. No. Home address
Waiver
I hereby waive my right under the Family Educational Rights and Privacy Act of 1974 to view the attached confidential letter of reference. I will not seek access to this reference letter in my file at the college or university listed above.
Signature of applicant Date Author of reference
Kevin Kelly Mathematics Department Lexington High School 251 Waltham Street Lexington, MA 02421