LPC Reference Form

Thank you for agreeing to complete this reference! Please note that the applicant has waived their right to view this information and all responses are confidential unless required by law. If you have any questions or comments about this form, please contact our office.

Step 1 of 3 - Referee Information

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  • Useful if we need to follow up with you about some aspect of this reference
  • Useful if we need to follow up with you about some aspect of this reference
    References from the applicant's relatives or minors are not accepted. We also do not accept references from full-summer LPC staff.