SELF Program Reference Request Form

In order to allow ample time for references to complete the recommendation form, this reference request should be submitted well in advance of the December 1 deadline for the SELF Program Application.

Once you submit this form, a link to an online reference form will be sent to the e-mail address of the reference you list below. Please ensure that you have listed the correct e-mail address for your reference.

It is your responsibility to ensure that your reference receives the e-mail and submits your recommendation by the deadline.

If your reference does not receive the link to submit a reccomendation, please contact engrself@ku.edu to confirm that your Reference Request Form has been submitted. 

Your First Name

Your Last Name

Your Email Address

According to FERPA of 1974, students are guaranteed access to educational records concerning them, unless that right is waived.

Yes, I waive my right to review recommendations submitted on my behalf.

No, I do not waive my right to review recommendations submitted on my behalf.

Reference First & Last Name

Reference Email Address

Submit Form