Application is due by Wednesday, May 1, Date of Birth: / / Age: Gender: Male Female. Parent/Guardian Name(s): Home Address: City: State: Zip:

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1 MSU COLLEGE OF EDUCATION SUMMER HIGH SCHOOL SCHOLARS PROGRAM APPLICATION Summer 2013 Monday, July 8 Friday, August 2, 2013 (11th Grade Only) Monday, July 22 Friday, August 2, 2013 (9th and 10th Grades) The MSU College of Education Summer High School Scholars Program is a residential program on the campus of Michigan State University, offering four weeks of college experience for current 11th graders and two weeks for current 9th and 10th graders. During this academic college preparation program, all travel, lodging, and meal expenses are covered for selected students as part of the program participation. The program is open only to current 9th-, 10th-, and 11th-grade students and is intended to increase college readiness, as well as nurture an interest in careers in education. Students who participated in the 2012 College of Education Summer High School Scholars Program are encouraged to re-apply for participation in the 2013 program. Application is due by Wednesday, May 1, Date: Student Name: Date of Birth: / / Age: Gender: Male Female Parent/Guardian Name(s): Home Address: City: State: Zip: Phone: ( ) - Address: High School you currently attend: Current grade level: Current high school grade point average: (You must attach a current copy of your high school transcript.) PLAN Score (if taken): Are you a member of a Young Educator s Society (YES) club? YES NO If yes, please provide the name of your YES club advisor : 1

2 Please rate your interest in attending Michigan State University. (circle one) No Interest Some Interest Likely Definite Please rate your interest in pursuing a career in teaching. (circle one) No Interest Some Interest Likely Definite Have you had any experiences in which you worked with a young person or with youth? YES NO If yes, please describe: How did you hear about the program? (check all that apply) 2012 College of Education Summer High School Scholars Program Participant School Counselor Michigan State University Representative College of Education Scholarship Website Family Member Other School Representative Other (Please Specify) ETHNIC/RACIAL GROUP (optional check all that apply) 1. White/Caucasian Non-Hispanic 2. Black/African American Non-Hispanic 3. Chicano/Mexican American 4. Hispanic 5. American Indian/Alaskan native Tribal Affiliation 6. Asian/Pacific Islander (Asian American) Please attach a written statement (300 words or less) in response to the following question: Why are you interested in attending the College of Education High School Scholars Program on the campus of Michigan State University? 2

3 Required Signatures: Student Signature: Parent/Guardian Signature: School Representative Signature: Please return all of the following application materials by Wednesday, May 1, 2013: CHECK-LIST Signed Application Completed Recommendation Form Copy of Transcript Essay PLEASE RETURN COMPLETED APPLICATION TO: James E. Neely, Jr. Academic Specialist Michigan State University Erickson Hall 620 Farm Lane, Room 518 East Lansing, MI (517) Fax:

4 MSU College of Education Summer High School Scholars Program School Representative RECOMMENDATION FORM The MSU College of Education Summer High School Scholars Program is a residential, academic college preparation program on the campus of Michigan State University (four weeks for current 11th-grade students and two weeks for current 9th- and 10th-grade students). All travel, lodging, and meal expenses are covered for selected students as part of program participation. The program is intended to increase college readiness, as well as nurture an interest in careers in education. Students seeking to participate in the program are required to submit the following recommendation form as a part of their application. Upon completion, we request that you return this form to the student in a signed, sealed envelope to be included with all other application materials, which are due to the program coordinator by Wednesday, May 1, Please return the completed form to student in time for mailing to arrive at MSU by that date. Thank you, College of Education Summer High School Scholars Program Name of Student: Name of School Representative: Title of School Representative: Address: Phone: ( ) - Address: 1. Knowledge of student (check all that apply): Student in my class Advisee Other (please specify): 2. Considering all of the students with whom I have worked, this student academically is in the: Top 5% Top 10% Other (please specify): 4

5 The MSU College of Education Summer High School Scholars will be required to reside on the campus of Michigan State University and participate in substantive academic and social skill development activities. Given this expectation, please rate the student s level of maturity to benefit from such an experience. Above Average Average Below Average Please describe notable attitudes, interests, skills, or experience of the applicant that you feel are relevant to the aims and goals of the Summer High School Scholars Program. If applicable, please describe any reservations you have about the applicant s ability to participate in the program. Overall Recommendation: I recommend the applicant without reservation as an excellent candidate for participation in the MSU College of Education Summer High School Scholars Program. On the whole, I recommend the applicant as a good candidate for participation in the MSU College of Education Summer High School Scholars Program. I have some reservations but feel that the applicant is a reasonable candidate for participation in the MSU College of Education Summer High School Scholars Program. Signature Date 5