COLLEGE CONNECTION Application Check List (please keep for your records) The following items must be submitted for an application to be considered: 1. College Connection Application 2. Student Essay 3. Parent/Guardian Statement/Essay 4. High School Transcripts 5. Teacher Evaluation (Teacher will send directly to Guidance Office) 6. Counselor Evaluation (Will be added directly to file) 7. Counselor Assessment of Student Credits For Graduation 8. Attendance and discipline report 9. SAT/SAT II/ACT test scores (if applicable) Student Responsibility I understand that as a student in the College Connection program, I am expected to participate fully in the program. This includes: Attending high school and Shasta College classes regularly. Planning academic schedules with my teacher/advisor. Meeting with my teacher/advisor before enrolling in or dropping classes. Taking advantage of Shasta College support services to complete classes successfully. Taking responsibility for self, both academically and socially. Notifying teacher/advisor immediately of any potential difficulty, which may negatively affect performance. Adhering to all rules, regulations, policies, procedures, etc., regarding student enrollment at Shasta College. Informing teacher/advisor when absent. Being responsible for student fees and costs above those incurred by the District. Committing to the year-long College Connection program Please return the completed application form to the counseling office no later than:. Please keep this page for your records
COLLEGE CONNECTION APPLICANT Name of Student Age My Shasta ID Date of Birth Name of Parents/Guardian: Mailing Address: Street # City State Zip Home Phone # Parent Cell phone# Student Cell phone# Parent Work Phone # Parent email Student email Educational Objectives For College Connection (Please check one) Program leading to one-year certificate/work opportunity Program leading to two-year associate degree/work opportunity Program leading to two-year associate degree/transfer to a four year college or university Program leading directly to a four year college or university List interested colleges and universities: What is your intended occupation or field of study? Name a current instructor at who can evaluate your readiness for the College Connection Program. If you are accepted into the College Connection Program, list any work hours and/or extracurricular activities planned for next year.
COLLEGE CONNECTION APPLICATION STUDENT ESSAY Discuss your reasons for selecting College Connection (as opposed to a traditional senior year) as well as your readiness for such a program. Consider your special qualities, talents, or abilities, past successful experiences, constructive ways of handling problems or challenges, and future goals. (Limit your essay to two typewritten pages) PARENT STATEMENT Discuss your child s readiness for College Connection. Consider his/her special qualities, and abilities, maturity level, self-directedness, motivational level, and past examples of success. (Please print or type)
CONFIDENTIAL CONFIDENTIAL - CONFIDENTIAL Please fill out and return to: COLLEGE CONNECTION Evaluation by Teacher has named you as the teacher who could best evaluate his/her readiness for the College Connection program next year. Please take a few moments to complete this form and return to the Guidance Office ASAP. 1. Has this student ever had problems with respect for authority? If so, please explain. 2. Has this student had a pattern of problems with either attendance or tardiness? If so, please explain. Applicant s Academic/Personal Characteristics : Circle one number for each 5=excellent; 4=good; 3=average; 2=below average; 1=poor) Motivation 5 4 3 2 1 Self-discipline 5 4 3 2 1 Intellectual Ability 5 4 3 2 1 Creative Qualities 5 4 3 2 1 Independence 5 4 3 2 1 Energy and Initiative 5 4 3 2 1 Warmth of Personality 5 4 3 2 1 Social Maturity 5 4 3 2 1 Manners, Personal Habits 5 4 3 2 1 Concern for Others 5 4 3 2 1 Reaction to Criticism 5 4 3 2 1 Sense of Responsibility 5 4 3 2 1 Respect Accorded by 5 4 3 2 1 classmates READINESS FOR COLLEGE CONNECTION: 5 4 3 2 1 Comments on above ratings: Teacher signature Date Printed name of teacher & course teaching
COLLEGE CONNECTION Evaluation by Counselor Name of Student: 1. Has this student ever had problems with respect for authority? If so, please explain. 2. Has this student had a pattern of problems with either attendance or tardiness? If so, please explain. 3. Has this student ever had or currently has an I.E.P.? Applicant s academic/personal Characteristics: Circle one number for each line (5= excellent, 4= good, 3= average, 2= below average, 1= poor) Motivation 5 4 3 2 1 Self-discipline 5 4 3 2 1 Intellectual Ability 5 4 3 2 1 Creative Qualities 5 4 3 2 1 Independence 5 4 3 2 1 Energy and Initiative 5 4 3 2 1 Warmth and Initiative 5 4 3 2 1 Social Maturity 5 4 3 2 1 Manners, Personal Habits 5 4 3 2 1 Concern of Others 5 4 3 2 1 Reaction to Criticism 5 4 3 2 1 Sense of Responsibility 5 4 3 2 1 Respect Accorded by Classmates 5 4 3 2 1 READINESS FOR COLLEGE CONNECTION: 5 4 3 2 1 Comments on the above ratings: Counselor Signature Printed Name of Counselor Date
Counselor Assessment of Student Credits (College Connection) TO BE FILLED OUT BY COUNSELOR AND INCLUDED IN APPLICATION Student Name: High School: Counselor: Please answer the following questions assuming that the student passes all courses in which he or she is currently enrolled. 1. What credits will still be needed for graduation and for A-G qualification. English Graduation A-G Mathematics Graduation A-G Physical Science Graduation A-G Life Science Graduation A-G VAPA Graduation A-G Foreign Language Graduation A-G Social Sciences Graduation A-G NON A-G Requirements Physical Education Vocational Art Advanced Math Proficiency PE Competency Computer Proficiency 2. How many credits will the student need to meet your graduation requirement? 3. Please list any additional graduation requirements that the student will need to complete. 5. Is the student an athlete? If so what NCAA Division I requirements is the student lacking? Counselor Signature