University Of Texas-Arlington-UB 1-Recommendation Form

Hello!

You are being asked to participate in offering a recommendation for a student who has applied to be part of the Upward Bound program at the University of Texas at Arlington!

Upward Bound is a college readiness program that serves students from low income or first generation families who demonstrate they have a strong dedication to attending college. We provide students with many opportunities including free access to tutoring, SAT/ACT Prep, a summer residency program at UTA, and scholarships. You can find out more about us HERE.

You should only be filling out this survey if you are a teacher who has had experience with the student whom has asked you for your recommendation. It will take approximately 10 minutes to complete the questionnaire.

If you have questions at any time about the survey or the procedures, you may contact upwardbound@uta.edu. Thank you very much for your time and support of your students.

Name of the Student you are Recommending*

First NameLast Name

High School Name*

Your Full Name*

First NameLast Name

Your email address*

example@example.com

What is your Job Position?*

TeacherCounselor

What course did you teach the student in?*

Please rate the student's ability in the following areas:*

	Highly	Capable (Top Performer) Capable	Neutral	Needs Improvement	Poor Performance
Critical Thinking
Leadership
Dedication to studies
Cooperation with peers
Self-Respect
Classroom Involvement
School Community Involvement
College Readiness
Desire for Achievement
Perseverance

Please offer any examples about this student's qualifications to be in a program that sets high expectations and demands excellence from its members.*

Do you have any reservations about recommending this student?*

Please sign to affirm this recommendation using your mouse/cursor in the box below.*

Type of Degree Plan:*

DistinguishedRecommendedOther

Cumulative GPA (4.0 scale):*

Credits Earned to Date:*

Credits Required for Graduation:*

Which endorsement is the student currently pursuing for graduation?*

Please Rate the student*

	Not Satisfied	Somewhat Satisfied	Satisfied	Very Satisfied
Has shown or expressed commitment toward completing a college preparatory curriculum
Has shown interest in postsecondary education
Is at appropriate level of maturity for grade level
Cooperates with school staff
Is achieving at his/her potential
Has good relationships with peers/classmates
Demonstrates leadership potential

Indicate the student's Most significant academic need (Check all that apply)*

Low Grade Point AverageLow achievement test scoresLow educaitonal aspirationsLack of challenging coursesLack of career goals and/or informationLimited English proficiencyLack of self confidence and/or social skills

Please sign to affirm this recommendation using your mouse/cursor in the box below.*

Upward Bound Recommendation Form

Teacher Recommendation

Counselor Recommendation