Counselor’s Recommendation Form
Any student wishing to join Upward Bound must have some type of academic need otherwise they cannot be admitted. In your opinion, does this student have a need for academic support? Please briefly explain.
Student Name:
First Name
Last Name
Student ID Number:
School Counselor Name:
*
First Name
Last Name
Email:
*
example@example.com
In reference to the student indicated above, please provide/ attach the information listed below:
Applicants’ Cumulative GPA
EOC scores, standardized test scores, AP test scores
High School Transcripts
Most recent grade report
Applicants’ Cumulative GPA:
Student’s attendance record:
Excellent
Good
Fair
Poor
Student’s motivation for enrolling in post-secondary education:
High
Medium
Low
Does student have limited English proficiency?
Yes
No
Is this student receiving any special accommodations or service? Please explain and attach documentations.
In your opinion, does this student have a need for academic support? Please briefly explain.
On the basis of academic potential/promise, how would you recommend this applicant?
Highly recommend.
Recommend
Recommend with reservations
do not recommend
On the basis of character and personal promise, how would you recommend this applicant?
Highly recommend.
Recommend
Recommend with reservations
do not recommend
Has the student ever been subject to school disciplinary action or suspension?
Yes
No
If yes, please explain:
School Counselor Signature
Date
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
mm-dd-yyyy
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