UCLA Amgen Scholars Program
Letter of Recommendation Waiver
APPLICANT INFORMATION
Name (first, middle, last)
Home Institution
E-mail Address
Phone Number
APPLICANT: Complete the Applicant Information section of this form. Print, sign and give the waiver form to your
recommender for submission with his/her letter of recommendation. Make a copy for your records and the faculty
mentor should receive a copy. If your recommender is not at your home institution, fax them this document. Submit
via fax (preferred) or mail. This form, along with the completed letter of recommendation, must be
received by Tuesday, February 1, 2022.
Under federal law, students have the right to inspect and review the letter(s) of recommendation contained in their
educational records. However, applicants may waive the right of access. The letter(s) will then remain confidential
between the UCLA Amgen Scholars Program and the recommender(s). Applicants are not required to waive their
right of access as condition for admission to the UCLA Amgen Scholars Program. All letters of recommendation,
whether written confidentially or not, will be given careful consideration in the admission decision. Applicants alone
must decide whether to waive their right of access.
The UCLA Amgen Scholars Program asks that you fill out, sign, and date the declaration below.
Applicant’s Waiver Declaration:
I have read the statements above and I understand that I am not required to waive the right of access under the Family
Educational Rights and Privacy Act of 1974 (“FERPA”) and any/or all other laws, regulations, or policies as a condition
for admission to the UCLA Amgen Scholars Program.
Please check the appropriate response.
I hereby waive my right of access to this letter of recommendation as provided by FERPA
I do not waive my right of access to this letter of recommendation as provided by FERPA
By typing my name in the space provided below I hereby certify to the best of my knowledge that all information submitted is
complete and correct. I understand that failure to disclose accurate information is grounds for immediate termination from this
program.
Signature of Applicant __________________________________________________ Date ______________
RECOMMENDER INFORMATION:
Name
Institution
E-mail Address
Phone Number
RECOMMENDER: To best assist the Amgen Faculty Review Committee, please write candidly about your
knowledge of the applicant and the applicant’s qualifications, including but not limited to:
• How long and in what capacity you have known the applicant
• The applicant’s motivation for graduate study versus aspiration to attend professional (e.g., medical) school
• The applicant’s qualifications and potential for research as well as academic success
If there are any other insights that you wish to share about the applicant, please do. Letters should be composed on
departmental letterhead.
Submit via email. All application materials must be received by Tuesday, February 1, 2022.
Email
AmgenSch@lifesci.ucla.edu
