Please return your completed application to your guidance counselor by January 31st!

Today’s Date: ______Site Applying to:Brighton High School

BASIC INFORMATION

First Name: ______Middle Initial: ______Last Name: ______

Gender: (circle one) Male Female Other Birth date (MM/DD/YY): ______

Street Address: ______

Apt. #: ______City: ______State: ______Zip: ______

Home Phone Number: ______Cell Phone Number: ______

Email: ______SSN: ______(OR Alien ID#: ______)

School Student ID Number: ______

How would you describe yourself? (you can choose more than one)

American Indian or Alaska Native / Asian, Asian American or Pacific Islander
Black or African American / Caucasian or White
Mexican or Mexican American / Puerto Rican
Hispanic, Latino or Latin American / Other: ______

What language do you feel MOST proficient in (reading, writing, speaking)? (please circle one)

English / Spanish / Chinese / French / Other (please specify):

Approximate family income (please circle one):

Less than $20,000 / About $20,000 to $40,000 / About $40,000 to $60,000 / About $60,000 to $80,000 / More than $80,000

Total Number of people in household (including yourself): _____

SCHOOL INFORMATION

High School: ______

Grade Level (please circle one) (If summer, what grade are you entering in the fall?): 10 11 12

Anticipated Graduation Date (MM/DD/YY):_____/______/______

Guidance Counselor/College Counselor Name: ______

Cumulative GPA (please circle one):

A (90-100) / B (80-89) / C(70-79) / D(65-69) / F(Below 65)

How did you learn about LGR? (please circle one)

School
Who within the school? ______/ Community Program (ex. Upward Bound)
Which one? ______
Friend / Internet
Church / Family Member
Parent / Other: ______

Do you participate in any of the following programs?

Bottom Line

IBA

Passport

Big Brothers Big Sisters

Tenacity

uAspire

BUILD

Upward Bound

Other: ______

ELIGILBILTY INFORMATION
Please circle the statement that applies to you:

I have never been enrolled in the Free or Reduced Price Lunch.

I am currently enrolled in or eligible for the Free or Reduced Price Lunch.

I was enrolled in the Free or Reduced Price Lunch, but I no longer am.

Everyone in my school receives a free lunch.

Please circle Yes/No

Have you attended an SAT preparation course before? Yes No

If yes, was it with LGR? Yes No

If LGR didn’t exist, would you be able to afford an SAT prep program such as Kaplan or The Princeton Review? Yes No

PARENT INFORMATION

Parent/ Legal Guardian 1:

Circle One : Mother Father Legal Guardian Other: ______

Name: ______Email: ______

Daytime Telephone: ______Evening Telephone: ______

Occupation: ______Full or Part Time (Circle One)

Highest Level of Education Completed by Parent/Guardian 1(please circle one):

Some high school / High school degree or GED / Some college / Received Associate’s Degree or 2-year degree / Received Bachelor’s Degree or 4-year degree / Received Graduate Degree

Parent/ Legal Guardian 2:

Circle One : Mother Father Legal Guardian Other: ______

Name: ______Email: ______

Daytime Telephone: ______Evening Telephone: ______

Occupation: ______Full or Part Time (Circle One)

Some high school / High school degree or GED / Some college / Received Associate’s Degree or 2-year degree / Received Bachelor’s Degree or 4-year degree / Received Graduate Degree

Highest Level of Education Completed by Parent/Guardian 2(please circle one):

Please list your other time commitments during the period in which you are applying to attend Let’s Get Ready!

ActivityDays of the week Times Dates*

1. ______

2. ______

3. ______

SAT TEST TAKING

Every student in the fall LGR program MUST take the May SAT and send his/her scores to LGR.

Do you agree to take the May SAT and send your scores to LGR? (please circle one) Yes No

Any student who does not qualify for Free/Reduced Lunch will need to pay the $50.00 SAT registration fee.

If applicable, do you agree to pay the $50.00 SAT registration fee? (please circle one) Yes No

Have you taken the SAT in the past or have you already registered for an upcoming SAT test date? If so, please list the date (month, year), whether or not you used a fee waiver to register, and whether or not you actually took the test.

SAT Date (month/year) / Did you register using a fee waiver? (please circle one) / Did you actually take the test on this date? (please circle one)
______/______/ Yes No / Yes No
______/______/ Yes No / Yes No

ESSAY QUESTION

Let’s Get Ready considers many factors when selecting students for the program. They include your reasons for wanting to attend college, your family background (income, whether you will be the first person in your family to attend college), what you will contribute to the program as part of the LGR team, and what you hope to gain through participation. Please tell us about yourself and why you are an excellent candidate for the program (If you need more space, feel free to attach a separate sheet)

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