Central Arizona College-UB-Counselor Recommendation

Upward Bound
Central Arizona College, 8470 N. Overfield Rd., Coolidge, AZ. 85128
Phone: (520) 494-5114 Fax: (520) 494-5295

Counselor Recommendation Form

Dear Counselor:

The student listed below is applying for admission into the Upward Bound (UB) Program of Central Arizona College. Your assessment of the student’s need for program services is an integral element in the admission process. Please give us your honest assessment of this student’s desire and ability to learn. Should you have any questions or concerns, please feel free to contact April Ortega, Upward Bound Project Director, at 520-494-5114.
Student's Name

First NameLast Name
Grade Level
School
Please check the academic, career, and personal needs of this student (please select at least three)

Predominately low income communityLack of career goals and/or need for accurate information on careersLow educational aspirationsLack of confidence, self-esteem, and/or social skillsRural IsolationLack of opportunity, support/guidance to take challenging college prep coursesDisconnected youth (foster care, homeless)Interest in careers in math and scienceLimited English proficiencyHigh mobility student (has moved more than 2 times in last 5 years).Diagnosed learning disabilityOther

Please evaluate the student’s current overall performance by checking one rating for each category:

	Excellent	Good	Fair	Poor	Inconsistent
Attendance (include tardiness)
Classroom Attitude/Behavior
Willingly participates in class
Motivation/eager to learn new things
Potential to Achieve College Readiness
Overall Academic Need

Based on my experience with the applicant, my recommendation to Upward Bound is as follows:

Highly RecommendRecommendRecommend w/ReservationDo Not Recommend
Please provide comments on motivation, behavior, personality, strengths or weaknesses that you feel are pertinent to the student’s performance in Upward Bound. Additional comments may be added on another paper.
Additional Comments Upload

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Counselor's Printed Name*

First NameLast Name
Counselor's Title
School Telephone
(999)999-9999
Email address*
example@example.com
Counselor's Signature*

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Date

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mm-dd-yyyy