College Of The Redwoods-UB-Recommendation Form

Upward Bound Program Application
Counselor/Teacher Recommendation Form

College of the Redwoods/UB
7351 Tompkins Hill Rd.
Eureka, CA 95501
(707) 476-4277 or (800) 641-0400 ext. 4277

Counselor/Teacher Recommendation for*

First NameLast Name

TO THE COUNSELOR/ TEACHER: Thank you for taking the time to recommend this student! The College of the Redwoods Upward Bound program is designed to assist students to prepare for and enroll in a college level educational program. Students can have academic deficiencies when entering the program but should show potential or motivation for college preparation. Our services include tutoring, academic and career guidance, financial assistance for academic needs, a summer residential program, and more. Your recommendation is very important in the selection process. Please be as specific as you can, and feel free to include any information you feel would be of help to us in our selection process.

Counselor/Teacher Name*

First NameLast Name

Position*

School*

Phone*

(999)999-9999

Email*

example@example.com

1. How long have you known the applicant?*

2. What special circumstances should we consider in evaluating this student's application (needs, strengths, etc.)?*

3. Is the student an English Language Learner?*

YesNo

4. Does the student have a documented disability?*

YesNo

5. Based on your knowledge of the applicant, please check the areas in which the student could use help or show improvement. These areas indicate whether or not the student has an academic need for our program.*

	Needed	Not Needed
Academic Achievement
Reading/Writing Skills
Social Skills
Study Habits
Leadership Skills
Motivation
Self-Confidence
Career Goals

Signature*

Date*

mm-dd-yyyy