• Student's Name * Required
  • (2019-2020 Academic Year)
  • (Cell)
    The student named above is applying for participation in our Upward Bound Program. Since an application cannot be evaluated until we have received this form, both the student and The Upward Bound Program would appreciate a prompt reply. Please answer each of the following questions:
  • Please rate this student.

  • Promptness * Required
  • Attendance * Required
  • Participation * Required
  • Class Preparation * Required
  • Respectfulness * Required
  • Resilience * Required
  • Self Motivation * Required
  • Overall, how would you rate this student’s ability to successfully participate in the Upward Bound Program? * Required
  • Date Format: MM slash DD slash YYYY
  • Upward Bound thanks you for taking the time to provide a thoughtful reference