Forward Service Corporation Upward Bound JAM-Recommendation Form

Upward Bound
Recommendation Form

The following student has applied to Forward Service Corporation’s Upward Bound program. Your assessment of this student would be appreciated. For those students in 9th grade, a recommendation from middle school staff is acceptable. For all other grades, a recommendation must be from high school staff.

Student Name*

First NameLast Name

School*

Other School*

Person Completing this Form

Name*

First NameLast Name

Email*

example@example.com

Title*

How long have you known this student?*

How well do you know this student?*

Very wellSomewhatNot very well

1. Based on your observations, please rate this student's performance and/or potential*

	Above Average	Average	Below Average	Unknown
Overall academic performance
Overall academic potential
Social skills/peer relations
Demonstrated leadership skills
School or class attendance
Determination/motivation for academic success
Attitude

2. What specific areas of academic or social need that Upward Bound may be able to address?*

3. What factors or circumstances may keep this student from pursuing a college education?*

4. What are some of this student’s academic or other strengths?*

5. Other comments or information that will assist us in assessing the needs and potential of this student.*

Signature of Person Completing Form*

Date*

mm-dd-yyyy