A. To be completed by applicant: (Please print or type)

Name:

I am applying for admission to the Chautauqua Institution Summer School of Art. Thank you for your assistance.

Student's signature and date:

B. To be completed by instructor: (Please print or type)

1. Name:

Institutional Affiliation (if any):

Address:

Phone & Fax:

E-mail Address:

2. Among the students I have taught, I would rate this applicant:

Poor Fair Average Good Excellent One of the best I have encountered

3. Please write a brief recommendation for this student in the space below or on a separate sheet of paper.

a. Your opinion of his or her abilities and commitment as an artist:

b. Your opinion of his or her ability to participate successfully in an intensive, communally-oriented summer program:

Instructor's signature and date: