Upward Bound Program

Teacher Recommendation Form

To the applicant: This recommendation must be completed by a teacher in an academic area such as math, science, English, history, or foreign language. The teacher should have known you for at least one semester. 


To the recommender: We seek students who have both academic promise and the need for our academic and advising services, so please provide a frank assessment of the student's strengths and needs as you have observed them. This information will be used only by Upward Bound staff. Upward Bounds will treat all information confidentially and only for purposes of evaluating the applicant's appropriateness for our program. 

Applicant's Name: ( Last, First MI) *
School: *
Teacher's Name: *
Subject: *
Level: *
How long was the applicant your student? *

Please rate the student according to the following criteria. 

1 - Low --- 5 - High

Assertiveness *
Motivation *
Integrity *
Cooperation (Helpfulness, positive, initiative, attitude) *
Potential (Exhibits the potential to succeed in college) *
Academic Strengths: *
Academic Weakness: *
In your opinion, this student (Check one)
Has the potential for success in post-secondary educational program.
At this time, the student has not yet exhibited potential for success in a post-secondary educational program.
Please comment on the student's motivation, effort and attitude. *
Please comment on the applicant's rapport and relationships with peers and adults. *
What are some challenges this applicant faces in preparing for, getting admitted to, and succeeding in education after high school that Upward Bound could assist with? *
What specific basic skills need to be developed? *
In what ways might participation in Upward Bound assist the applicant in his/her academic and personal development? *
General comments: *
Signature: *
Signature Type: SMS    Start Over
After validation, the cell phone number will become part of the electronic signature.
Cell Phone Number:

Date: *