Marian University-UBMS-Recommendation Form

To the student: This form must be filled by a current or prior school counselor, teacher, coach, or student services staff who has good knowledge abou you as a student. Contact them to let them know that you would them to recommend you.

To the recommender: Marian University's UBMS program is designed to prepare and motivate students for success in postsecondary education. Your evaluation is beneficial to us in determining if the student may have a chance succeed in this program. If applicable, include additional comments you deem will help solidify the reasons why this student should be accepted into the program. Upon completion, please submit the form directly on this platform or send it via email to trio.ubms@marianuniversity.edu. This will help complete the student's application process. If you haven't met this student yet, please indicate by checking NA for all areas.

1. Recommender

Name*

First NameLast Name

School

Title/Role

Email Address*

example@example.com

Phone Number

(999)999-9999

2. Student's First Name, Middle Initial, and Last Name

First NameMiddle InitialLast Name

3. Student grade level

9101112

4. Has this student demonstrated interests in STEAM careers or other careers requiring either a 2-year or 4-year degree?

YesSomewhat YesSomewhat NoNo

5. Current Cumulative GPA

6. To the best of your ability, please rate this student in the following areas

	Above Average	Average	Below Average	N/A
Grasps fundamental ideas and concept
Integrates complex information
Accepts criticism well
Assumes responsibility
Is motivated to achieve
Has good work habits; is disciplined
Is sensitive to the needs of others
Has foundation in basic skills
Demonstrates leadership skills
Demonstrates an appropriate maturity level
Shows regard for rules/regulations
Overall academic potential(s)

7. Based on your experience with the student, please indicate their level of needs in the categories below. (check any and all that apply)

	High	Moderate	Low	Unknown
Academic performance and/or potential (Math, Science, ELA)
Post high school educational aspirations
Opportunity and support to take challenging courses
Guidance on career interests and/or options
Confidence level and/or self-esteem
Social and/or human relations skills
Overall behavior and/or attitude

8. Did student score as Proficient(652 or higher) on the 8thgradeForwardExam in ELA?

YesNo, student scored at Basic or Minimal Performance.NA student did not take assessment

9. Did student score as Proficient(667 or higher) on the 8thgradeForwardExam in Math?

YesNo, student scored at Basic or Minimal Performance.NA student did not take assessment

10. Please provide additional comments. We would appreciate comments concerning the student's needs for and willingness to be involved in college and career preparation activities beyond their regular school settings; both during the school year and the summer.

11. Please provide an overall recommendation of acceptance for the student

Highly recommendRecommendRecommend with reservationDo not recommend

12. Electronic Signature*

Counselor-Teacher Recommendation Form