University Of Maine-Orono-UBMS-Reference Request Form

The University of Maine Upward Bound requires four references to complete your application. Please consider your options, ask your cholces if they are willing and able to provide a reference, and then list them on this form. Upward Bound staff will send electronic forms via email to your references. Please let us know if you have a reference who needs accommodations and we will work with them.
Student Name*

First NameMILast Name
Email*
example@example.com
High School*
Best Phone Number*
(999)-999-9999

Reference Request
Guidance Reference
Guidance Name*

First NameLast Name
High School*
Email*
example@example.com
Math or English Teacher Reference
Teacher Name*

First NameLast Name
High School*
Email*
example@example.com
Teacher of Choice Reference - Students in 9th grade may list a teacher from middle school or a current teacher. Students in 10th or 11th grade may list any high school teacher.
Teacher Name*

First NameLast Name
High School*
Email*
example@example.com
Personal Reference - Please ask an adult who knows your character and personality. You could ask a teacher, coach, advisor, mentor, employer, club leader, or community member. Please do not ask a family member or high school friend.
Name*

First NameLast Name
Email*
example@example.com
If any of your references need accomodations to complete the form (ie no email or internet, sight impaired, or other need), please explain so we can follow up with them.