MCUB: School Personnel Evaluation

MILLS COLLEGE UPWARD BOUND APPLICATION
To the Student Applicant: Send this form to your TEACHER OR COUNSELOR

Student Name Student Name First Last
Student's Grade Level
To the TEACHER OR COUNSELOR: The student listed above is currently applying for admission into the Upward Bound Program at Mills College. Please answer the following questions to the best of your knowledge. Your careful evaluation will assist us in gaining a more complete picture of the student applicant.
How long have you known the student
The student’s attendance record
The student’s overall classroom behavior
Upward Bound is a college bound program. What support does this student need to be successful in high school and in college?
Applicant’s academic needs as checked below will be used to prioritize selection. Check all that apply. (Please check at least one)

Applicant’s academic needs as checked below will be used to prioritize selection. Check all that apply. (Please check at least one) Low grade point average Low achievement test scores Limited proficiency in English Lack of confidence, self-esteem, and/or social skills Low educational aspirations Predominately low income community Low grade point average and low educational Rural isolation aspirations Low high school grade point average and Interest in careers in math and science Lack of opportunity, support, and/or guidance to achievement test scores take challenging college preparation courses Low achievement test scores and low educational aspirations New Learning Disability Lack of career goals and/or need for accurate information on careers Other Other
Are you aware of any circumstances (personal, financial or academic) that may affect the student’s performance in school?
If yes, please explain.
Maximum of 500 words allowed. Currently Entered: 0 words.
Please comment on the student’s relative strengths, weaknesses and abilities; and his/her potential for benefiting from participation in the Upward Bound Program.
The student is motivated towards college
Recommendation
Teacher or Counselors Name Teacher or Counselors Name First Last
Teacher or Counselors

Draw or Type

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Full Name

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Date Date / MM / DD YYYY
Email
Phone Phone - ### - ### ####
Position
Name of High School/Middle School