Fort Valley State University-UB-2025 Counselor Recommendation

This student is applying for admission into the Fort Valley State University Upward Bound Program. Upward Bound is a federally funded TRIO program that provides supplemental college preparation assistance, tutoring, and guidance to potential first-generation college students who meet specific federal guidelines. Regulations that govern the Upward Bound Program require documentation of the student’s eligibility; therefore, we are requesting that the School Counselor or authorized custodian of student records complete this form and submit copies of the document(s) listed below. Your recommendation is critical in helping us identify those students with a need for our services and have potential for success in college.

Student Name:

First NameLast Name

Student Grade Level:

Current GPA:

Academic program of study:

Other

To be completed by school counselor or records custodian:

Counselor Name:

First NameLast Name

School Name:

Email:

example@example.com

Phone:

(999)999-9999

Please rate the applicant on the following traits (check one per row):

Rows	Excellent	Above average	Average	Below average
Academic potential:
Motivation to succeed:
Attendance:
Behavior / conduct:

Has the student ever been suspended or had serious disciplinary action?

If yes, please explain:

Does the student have an IEP or 504 plan?

If yes, which one:

If given the opportunity and guidance, do you feel this student can enroll in and be successful in post-secondary education?

Do you recommend this student for the Upward Bound Program?

Additional comments:

Counselor Signature:

Date:

mm-dd-yyyy

(Attach/Upload most recent transcript and Georgia Milestones/EOCT Test Scores)

Upward Bound Application

Counselor Recommendation Form