Savannah State University-UB-Teacher Recommendation

SAVANNAH STATE UNIVERSITY
UPWARD BOUND PROGRAM
BOX 20488 ♦ 3219 COLLEGE STREET ♦ SAVANNAH, GEORGIA 31404
(912) 358-3477 ♦ FAX (912) 358-3687

Teacher's/Counselor's Recommendation

Please give specific reasons for recommending this student to the Upward Bound Program and return to the above address.

Student Name

First NameLast Name

Grade

School

The student is being recommended to participate in the Savannah State University Upward Bound Program.

YesNo

Student's grade point average

High School Curriculum

Does the student intend to pursue post-secondary education?

YesNo

If no, why?

Intellectual ability and achievement: How would you rate the student’s academic ability and motivation?

	Poor	Below Average	Average	Above Average
Academic Ability
Motivation

School Attendance

RegularIrregular

Has the student had any social, physical (health), or psychological problems?

YesNo

If yes, please explain.

Please give specific reason for recommending this student and provide any additional information which will assist us in assessing the student’s personal and academic qualities as a potential participant.

Teacher Name*

First NameLast Name

Teacher Email*

example@example.com

Teacher Signature

Date

mm-dd-yyyy

Subject you teach student

Telephone

(999)999-9999