is interested in participating in the Upward Bound Program at Virginia State
University. The Upward Bound Program is a preparatory college program. The purpose of the
program is to increase the academic skills and motivational levels of the participants. Please
complete this form and return it to the Guidance office or the Upward Bound office.
1. How long and under what conditions have you known the candidate?
2. Are you familiar with the Upward Bound Program? Yes No
Do you think this is a good program for this candidate? Yes No
3. Do you think this student is a good candidate for college? Yes No
(Please use the space below to explain your answer)
4. Please indicate your judgement of the candidate by checking the appropriate space below:
Below Average
Above Average
Grasps fundamental ideas
Ability to get along with others
Ability to adjust to new situations
Emotional Stability
Desire to achieve
Social Awareness and Concern
Completes Assignments
Have good work habits, is disciplined
Has positive sense of self
Has foundation in basic skills
Shows potential for more advanced study
ADDITIONAL COMMENTS (Please place additional comments on reverse side):
Signed: Position:
School: Date: