Cuesta College/Workforce Development Projects
Summer Bridge Application 2018
Dates: Monday-Thursday 8:00am-4:00pm, June 18- July 19, 2018
Student Name: ____________________________________ High School: _____________________________
Address: _____________________________________ City: _____________________Zip Code: __________
Telephone #: _____________________ E-mail Address: ___________________________________________
Birth Date: _____________ Age: ________ Current Grade: _____________
Ethnicity: __________________________________________ First (Native) Language: __________________
Personal Reference: _________________________________________ Telephone #/E-mail Address: _________________________
• Are you currently attending continuation school or an alternative education program?
• Do you have a verified learning disability or have you received Education Resources Services?
• Do you participate in ILP (Independent Living Program) and/or do you live in a group home or foster care?
• Have you taken any of the following courses at your high school (If yes, circle course): PEDS 110 PEDS 120
1. What were your grades (GPA) on your last report card?
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2. What obstacles have you encountered that you feel prevents your academic and career-planning success?
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3. How have you worked to overcome these obstacles? Who is your support person?
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4. What are your plans, if any, for attending college? What career(s) are you thinking of pursuing?
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5. How will your experience in the Summer Bridge Program help you in your future academic success and work readiness?
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Applicant’s Signature Parent/Guardian Signature
**APPLICATIONS CAN BE E-MAILED OR FAXED TO (805)546-3181 BY FRIDAY, APRIL 27th**
For more information, contact Lily Holzner at (805)546-3252 or lily_holzner@cuesta.edu
