Virginia Union University-UB-Counselor Recommendation

TO THE COUNSELOR: Thank you for taking the time to recommend this student! The VUU Upward Bound Program is designed to assist students to prepare for and enroll in post-secondary studies. 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 believe would be of help to us in our selection process.

Counselor Name*

First NameLast Name

Student's Name

First NameLast Name

Student Social Security Number

999-99-9999

Student DOB

mm-dd-yyyy

Please return a copy of the student’s official high school transcript with this form.

Type of Degree Plan

StandardAdvanced StudiesOther

Cumulative GPA

Credits earned to date

Credits required for graduation

Current Grade

Attendance Record

ExcellentGoodFairPoor

Student’s motivation for enrolling in Post-Secondary Education

HighLow

In your opinion, what is this student’s most significant academic need?

Please provide any additional information regarding this applicant. (i.e. has special academic needs, e.g. learning disabilities, limited English proficiency, special classes). Please elaborate if applicable.

Please comment on the student’s strengths, weaknesses, abilities, and special talents.

Rows	Excellent	Good	Fair	Poor	Not Observed
Academic Performance
Attendance
Motivation
Self-Discipline
Ingenuity/Imagination
Interpersonal Skills
Leadership Ability
Communication Skills
Initiative
Integrity
Responsibility
Influence on Peers
Emotional Stability

1. Is there parental involvement?

YesNo

2. Has the student been involved in disciplinary action?

YesNo

3. Will they benefit from participation in the Upward Bound Program?

YesNo

4. Additional evaluation suggested?

YesNo

5. Will the student need additional services to be successful?

YesNo

Does the student currently require special education services/accommodations (describe)

Print Name

First NameLast Name

Title

School

Signature

Email Address*

example@example.com

Date

mm-dd-yyyy