Counselor Recommendation Form
Please ensure that all parts of the recommendation are completed and signed.
This form must be completed using blue or black ink.
The student listed below is applying to join the Upward Bound Program at Somerset Community College. We seek recommen-
dations from one teacher and one guidance counselor at the school the student attends to ensure that we are admitting the
best students to our program. The questions on this recommendation will help us assess the student’s willingness and ability to
attend all services offered as well as to learn more about their academic ability. We appreciate your honest and candid answers
to all questions, and all information on this form will be held in condence.
Please add this recommendation in a sealed envelope to the student’s application and return it to the Upward Bound ofce as
directed by the UB staff member who serves your school. If you have any questions, please contact us at 270-858-6508 or e-
Student Name_______________________________________School________________________________
Would you recommend admitting this student to Upward Bound? Yes No
Explanation of your recommendation:___________________________________________________________
Please rate the student on each of the following: (check one)
Academic Performance Excellent Good Fair Poor
Motivation Excellent Good Fair Poor
Maturity Excellent Good Fair Poor
Dependability & Reliability Excellent Good Fair Poor
Problem Solving Skills Excellent Good Fair Poor
Attendance Excellent Good Fair Poor
Ability to attend overnight or extended trips Excellent Good Fair Poor
Is this student interested in attaining a four-year college/university degree? Yes No Unsure
Do you feel this student has the ability/potential to do college level work? Yes No Unsure
Do you feel this student would attend? School Visits Yes No Unsure
Saturday Academies Yes No Unsure
Summer Focus Yes No Unsure
What are some challenges this student faces in preparing for, getting admitted to and succeeding in education
after high school?_________________________________________________________________________
Additional Comments:_______________________________________________________________________
Counselor Signature_____________________________________________Date_____________________
Please circle if the student completed the following courses by the end of 8th grade: Pre-Algebra Algebra Geometry
Please circle the score for the student’s 8th grade K-PREP test: Math: Novice Apprentice Procient Distinguished
Reading: Novice Apprentice Procient Distinguished
Student achieved a GPA of 2.5 or higher for the most recent school year? Yes No
Does the student have an IEP? (If yes, please attach a copy.) Yes No
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