South Mountain Community College

South Mountain Community College

Upward Bound

Counselor/Teacher Referral

Dear Counselor/Teacher:

The Upward Bound Program at South Mountain Community College (SMCC) is a FREE college preparatory program funded by the United States Department of Education. Our purpose is to assist and motivate students to succeed and graduate from high school, and enroll and complete a postsecondary education of their choice. Our Upward Bound Program will serve a total of 50 students from Central and SouthMountainHigh Schools in a variety of ways.

We will be helping your student(s) improve their academic skills through weekly tutoring after school, as well as classes in math, science, English, foreign language, and study skills every other Saturday during the school year and the 6-week summer program at SMCC. The Upward Bound program is federally funded and it is required that a majority of the participants meet guidelines set forth by the Department of Education. Participants must be either low income or potential first-generation college students.

Due to the limited number of participants we are allowed to serve we are asking students to complete an application. The applicant will complete the “Student Application and Personal Statement” section of this application. We are asking their parent/guardian to complete the “Parent/Guardian Information” and we are asking you to fill out the “Counselor/Teacher Referral”. This referral form will aid us in our selection process. We ask that you complete the form and return it in a sealed envelop to our Upward Bound on-site contact’s mailbox:

• Berlinda Vigil @ Central High School
• Delia Araiza @ South Mountain High School

If you have any questions regarding this program or if you would like to recommend a student to the program, please feel free to contact the Upward Bound office at (602) 305-5676 or Thank you for your assistance and we look forward to working with your students!

Sincerely,

Ruben Saenz

TRIO Upward Bound Director

South Mountain Community College

SouthMountainCommunity College

Upward Bound

Counselor/Teacher Referral

Student Last Name: First:

Name of School: Referring Counselor/Teacher:

1. Does the applicant have the desire to pursue a post-secondary education? (Yes) or (No)

1. Would the applicant benefit significantly from academic support beyond that provided in the

high school? If yes, please check all academic areas that apply.

English Composition/Literature___ Mathematics ___Science ___ Foreign Language ___

English as a Second Language____ Other subjects: ______

1. Is the applicant on track to graduate with his/her class? (Yes) or (No)

1. What is the expected high school graduation date? ______

1. Does the applicant have a good attendance record? (Yes) or (No)

1. Does the applicant have a discipline problem in school? (Yes) or (No)

1. Has the applicant passed the math proficiency test required by the district? (Yes) or (No) or (N/A)

1. Has the applicant passed the reading proficiency test required by the district? (Yes) or (No)or (N/A)

1. What is the applicant’s current cumulative GPA? ______Grade Level: ______

Please provide any additional comments that will assist TRIO personnel in the selection process.

Referring Counselor/Teacher Signature: ______Date: ______

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