UPWARD BOUND - SCHOOL COUNSELOR ASSESSMENT FORM

Transcription

1 UPWARD BOUND - SCHOOL COUNSELOR ASSESSMENT FORM Upward Bound is a FREE college preparatory program for first-generation and income-qualified students from the select target high schools. The program is federally funded through the U.S. Department of Education and is free to all participants. The services of the Upward Bound Programs assist students in exploring college and career opportunities, preparing them to enter and succeed in postsecondary education upon graduation from high school. The student named on this form is applying to the Upward Bound Programs. We appreciate your careful and complete assessment of the student. The priority deadline is Wednesday, April 30 th Please mail or fax this form to the address listed below: UPWARD BOUND PROGRAMS UNIVERSITY OF NEVADA, RENO 203 Edmund J. Cain Hall/0062 Reno, NV Phone (775) Fax (775) upwardbound@unr.edu Student Name (Print) Current Grade Level School How long have you known the applicant? Counselor Name (Print) Counselor Signature Date Please provide three reasons this student will benefit from Upward Bound. In what academic areas does this student need assistance? Please describe the commitment of the student and his/her family to academic success.

2 Applicant Name: High School: Please complete both sections 1 and 2 of this table. The qualities and needs in Section 2 described are federal categories that need to be reported to demonstrate that Upward Bound is in compliance with federal regulations. 1- Please check the qualities which best describe the commitment, talent and current skills of Participates regularly in class discussions and activities Shows interest in learning and seeks academic challenge Is punctual and completes assignments on time Capable of performing at higher personal and academic level Demonstrates leadership abilities Is organized and uses time effectively Behaves in a responsible and relatively mature manner Is responsible, self-directed and can work independently Desire to pursue education beyond high school 2- Please check the academic, career, and personal needs of GPA: < 2.5 (low GPA) Low achievement test scores Low educational aspirations Low grade point average Disconnected youth (foster care, homeless, juvenile justice) Limited English proficiency Diagnosed learning disability Lack of opportunity, support and/or guidance to take challenging college preparation courses Lack of career goals and/or need for accurate information on careers Lack of confidence, self-esteem, and/or social skills Interest in careers in Math and/or Science Predominantly low-income community Rural isolation Other: Please evaluate the student s current overall performance by circling one rating for each category: Attendance (include tardiness): excellent good fair poor inconsistent Classroom Attitude/Behavior: excellent good fair poor inconsistent Maturity Level: excellent good fair poor inconsistent Work Ethic: excellent good fair poor inconsistent Motivation: excellent good fair poor inconsistent Potential to Achieve College Readiness: excellent good fair poor inconsistent Based on my experience with the applicant, my recommendation to Upward Bound is as follows: ( ) Highly Recommend ( ) Recommend ( ) Recommend w/reservation ( ) Do Not Recommend Note: If you select the categories Recommend w/ Reservation or Do Not Recommend please explain. COMMENTS OR ADDITIONAL INFORMATION: (You may attach an extra sheet if further comments are applicable.)

3 Applicant Name: High School: UPWARD BOUND ENGLISH TEACHER ASSESSMENT FORM Upward Bound is a FREE college preparatory program for first-generation and income-qualified students from the select target high schools. The program is federally funded through the U.S. Department of Education and is free to all participants. The services of the Upward Bound Programs assist students in exploring college and career opportunities, preparing them to enter and succeed in postsecondary education upon graduation from high school. The student named on this form is applying to the Upward Bound Programs. We appreciate your careful and complete assessment of the student. The priority deadline is Wednesday, April 30 th Please mail or fax this form to the address listed below: UPWARD BOUND PROGRAMS UNIVERSITY OF NEVADA, RENO 203 Edmund J. Cain Hall/0062 Reno, NV Phone (775) Fax (775) upwardbound@unr.edu Student Name (Print) Current Grade Level School How long have you known the applicant? Teacher Name (Print) Teacher Signature Date Please provide three reasons this student will benefit from Upward Bound. In what academic areas does this student need assistance? Please describe the commitment of the student and his/her family to academic success. Applicant Name: High

4 School: Please complete both sections 1 and 2 of this table. The qualities and needs in Section 2 described are federal categories that need to be reported to demonstrate that Upward Bound is in compliance with federal regulations. 3- Please check the qualities which best describe the commitment, talent and current skills of Participates regularly in class discussions and activities Shows interest in learning and seeks academic challenge Is punctual and completes assignments on time Capable of performing at higher personal and academic level Demonstrates leadership abilities Is organized and uses time effectively Behaves in a responsible and relatively mature manner Is responsible, self-directed and can work independently Desire to pursue education beyond high school 4- Please check the academic, career, and personal needs of GPA: < 2.5 (low GPA) Low achievement test scores Low educational aspirations Low grade point average Disconnected youth (foster care, homeless, juvenile justice) Limited English proficiency Diagnosed learning disability Lack of opportunity, support and/or guidance to take challenging college preparation courses Lack of career goals and/or need for accurate information on careers Lack of confidence, self-esteem, and/or social skills Interest in careers in Math and/or Science Predominantly low-income community Rural isolation Other: Please evaluate the student s current overall performance by circling one rating for each category: Attendance (include tardiness): excellent good fair poor inconsistent Classroom Attitude/Behavior: excellent good fair poor inconsistent Maturity Level: excellent good fair poor inconsistent Work Ethic: excellent good fair poor inconsistent Motivation: excellent good fair poor inconsistent Potential to Achieve College Readiness: excellent good fair poor inconsistent Based on my experience with the applicant, my recommendation to Upward Bound is as follows: ( ) Highly Recommend ( ) Recommend ( ) Recommend w/reservation ( ) Do Not Recommend Note: If you select the categories Recommend w/ Reservation or Do Not Recommend please explain. COMMENTS OR ADDITIONAL INFORMATION: (You may attach an extra sheet if further comments are applicable.) Applicant Name: High School: UPWARD BOUND MATH TEACHER ASSESSMENT FORM

5 Upward Bound is a FREE college preparatory program for first-generation and income-qualified students from the select target high schools. The program is federally funded through the U.S. Department of Education and is free to all participants. The services of the Upward Bound Programs assist students in exploring college and career opportunities, preparing them to enter and succeed in postsecondary education upon graduation from high school. The student named on this form is applying to the Upward Bound Programs. We appreciate your careful and complete assessment of the student. The priority deadline is Wednesday, April 30 th Please mail or fax this form to the address listed below: UPWARD BOUND PROGRAMS UNIVERSITY OF NEVADA, RENO 203 Edmund J. Cain Hall/0062 Reno, NV Phone (775) Fax (775) upwardbound@unr.edu Student Name (Print) Current Grade Level School How long have you known the applicant? Teacher Name (Print) Teacher Signature Date Please provide three reasons this student will benefit from Upward Bound. In what academic areas does this student need assistance? Please describe the commitment of the student and his/her family to academic success. Applicant Name: School: High Please complete both sections 1 and 2 of this table. The qualities and needs in Section 2 described are federal

6 categories that need to be reported to demonstrate that Upward Bound is in compliance with federal regulations. 5- Please check the qualities which best describe the commitment, talent and current skills of Participates regularly in class discussions and activities Shows interest in learning and seeks academic challenge Is punctual and completes assignments on time Capable of performing at higher personal and academic level Demonstrates leadership abilities Is organized and uses time effectively Behaves in a responsible and relatively mature manner Is responsible, self-directed and can work independently Desire to pursue education beyond high school 6- Please check the academic, career, and personal needs of GPA: < 2.5 (low GPA) Low achievement test scores Low educational aspirations Low grade point average Disconnected youth (foster care, homeless, juvenile justice) Limited English proficiency Diagnosed learning disability Lack of opportunity, support and/or guidance to take challenging college preparation courses Lack of career goals and/or need for accurate information on careers Lack of confidence, self-esteem, and/or social skills Interest in careers in Math and/or Science Predominantly low-income community Rural isolation Other: Please evaluate the student s current overall performance by circling one rating for each category: Attendance (include tardiness): excellent good fair poor inconsistent Classroom Attitude/Behavior: excellent good fair poor inconsistent Maturity Level: excellent good fair poor inconsistent Work Ethic: excellent good fair poor inconsistent Motivation: excellent good fair poor inconsistent Potential to Achieve College Readiness: excellent good fair poor inconsistent Based on my experience with the applicant, my recommendation to Upward Bound is as follows: ( ) Highly Recommend ( ) Recommend ( ) Recommend w/reservation ( ) Do Not Recommend Note: If you select the categories Recommend w/ Reservation or Do Not Recommend please explain. COMMENTS OR ADDITIONAL INFORMATION: (You may attach an extra sheet if further comments are applicable.) Applicant Name: High School: UPWARD BOUND SCIENCE TEACHER ASSESSMENT FORM

7 Upward Bound is a FREE college preparatory program for first-generation and income-qualified students from the select target high schools. The program is federally funded through the U.S. Department of Education and is free to all participants. The services of the Upward Bound Programs assist students in exploring college and career opportunities, preparing them to enter and succeed in postsecondary education upon graduation from high school. The student named on this form is applying to the Upward Bound Programs. We appreciate your careful and complete assessment of the student. The priority deadline is Wednesday, April 30 th Please mail or fax this form to the address listed below: UPWARD BOUND PROGRAMS UNIVERSITY OF NEVADA, RENO 203 Edmund J. Cain Hall/0062 Reno, NV Phone (775) Fax (775) upwardbound@unr.edu Student Name (Print) Current Grade Level School How long have you known the applicant? Teacher Name (Print) Teacher Signature Date Please provide three reasons this student will benefit from Upward Bound. In what academic areas does this student need assistance? Please describe the commitment of the student and his/her family to academic success. Applicant Name: School: High Please complete both sections 1 and 2 of this table. The qualities and needs in Section 2 described are federal categories that need to be reported to demonstrate that Upward Bound is in compliance with federal regulations.

8 7- Please check the qualities which best describe the commitment, talent and current skills of Participates regularly in class discussions and activities Shows interest in learning and seeks academic challenge Is punctual and completes assignments on time Capable of performing at higher personal and academic level Demonstrates leadership abilities Is organized and uses time effectively Behaves in a responsible and relatively mature manner Is responsible, self-directed and can work independently Desire to pursue education beyond high school 8- Please check the academic, career, and personal needs of GPA: < 2.5 (low GPA) Low achievement test scores Low educational aspirations Low grade point average Disconnected youth (foster care, homeless, juvenile justice) Limited English proficiency Diagnosed learning disability Lack of opportunity, support and/or guidance to take challenging college preparation courses Lack of career goals and/or need for accurate information on careers Lack of confidence, self-esteem, and/or social skills Interest in careers in Math and/or Science Predominantly low-income community Rural isolation Other: Please evaluate the student s current overall performance by circling one rating for each category: Attendance (include tardiness): excellent good fair poor inconsistent Classroom Attitude/Behavior: excellent good fair poor inconsistent Maturity Level: excellent good fair poor inconsistent Work Ethic: excellent good fair poor inconsistent Motivation: excellent good fair poor inconsistent Potential to Achieve College Readiness: excellent good fair poor inconsistent Based on my experience with the applicant, my recommendation to Upward Bound is as follows: ( ) Highly Recommend ( ) Recommend ( ) Recommend w/reservation ( ) Do Not Recommend Note: If you select the categories Recommend w/ Reservation or Do Not Recommend please explain. COMMENTS OR ADDITIONAL INFORMATION: (You may attach an extra sheet if further comments are applicable.)