Volunteers Of America-Los Angeles-UB-Recommendation Form

TEACHER/COUNSELOR RECOMMENDATION
Student Name:

First NameLast Name
Grade:
Dear Teacher/Counselor,

This student has applied to participate in the Upward Bound program, a project funded by the United States Department of Education, which is designed to assist eligible students to enter and succeed in college. The information requested will help us in determining the student’s eligibility to participate. Please complete this portion of the form by adding appropriate comments as needed. Thank you for your cooperation.

Please rate the student’s skills and/or deficiencies in each of the following areas:

	Strongly Agree (4)	Agree (3)	Disagree (2)	Neutral (1)
Demonstrates responsible behavior
Has strong social/interpersonal skills
Has strong study skills
Would benefit from supplemental career guidance
Has a good attendance/punctuality record
Has potential for post-secondary success

Please indicate the items in which you feel that Upward Bound can support the student:

Financial LiteracyTutoringCareer/College ExplorationTesting PreparationSelf-Esteem/Social SkillsOther
Please provide any additional comments/information about the student’s need for the Upward Bound program:
Name of Teacher/Counselor:*

First NameLast Name
Email:*
example@example.com
Date

MonthDayYear
mm-dd-yyyy
Signature of Teacher/Counselor

Clear

TEACHER/COUNSELOR RECOMMENDATION