Student:  Please print and fill out the first four lines of this form.  Give it to the faculty member whom you wish to serve as your reference. 
Faculty Member:  Please return this form directly to Mrs. Dorn in Alumni 225.

For the Faculty Member's Use Only

The above-named student has come to me for a reference to become a peer tutor in CADE.  I understand that peer tutors are required to have received at least a "B+" or higher in all courses for which s/he provides tutoring.  My recommendation is as follows:

¨  I unconditionally endorse this student
¨  I endorse this student with the following reservations:  ______________________
¨  I do not endorse this student.

Additional Comments: ____________________________________________________________

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Faculty Member's Signature                     Date