PROGRAM SUMMARY. For further information you may contact the program coordinator, Leslie Ramirez, at

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1 PROGRAM SUMMARY PROGRAM NAME: * * * * * * * * * * * * * * * * * * * * * * * * * * * * The at the University of Colorado Denver is an academic enhancement program. The program is designed to adequately prepare first-generation college bound students in grades 7 th and 8 th to enroll in a college curriculum and successfully complete their secondary school career. The Program will offer students the opportunity to engage in a wide range of pre-college activities throughout the academic year. The academic component will offer students monthly Saturday Academies consisting of basic study skills (i.e. effective note taking, test preparation, effective listening, etc.). Students will also be exposed to supplemental academic instruction, communication skills development, career exploration, high school transition preparation, parent partnership workshops, and a variety of cultural enrichment activities. The Program serves as a precursor to the Pre-Collegiate Development Program for high school students. Students who successfully complete the Program with a minimum of a 2.75 cumulative grade point average (GPA) or better will then be admitted to the Pre-Collegiate high school program at the beginning of their freshman year. Once a month on a Saturday, students will participate in academies held on Auraria Campus. These academies will be held from 8:00 a.m. to 12:00 p.m., and all students will be required to attend. Round trip RTD bus fare and lunch will be provided to participants by the Program. The Academy schedule for the 2015 Spring Semester is as follows: Date: Dec. 13 th Jan. 3 rd Feb. 7 th Mar. 7 th April 11 th April TBD Saturday Academies: New Student/Parent orientation Interpersonal Skills Explore Exam Conflict Resolution Health Professions Opportunity Day (hpod) La Raza Youth Leadership Conference Eligibility- The student selection criteria are as follows: Students MUST: 1) Attend a target middle school; 2) Be a first generation college bound student (neither of whose natural or adoptive parent(s) received a baccalaureate degree); 3) Have a minimum of a 2.75 cumulative GPA; and In addition, the student MUST also meet one or more of the following requirements: 1) Be a member of a one parent family; 2) Be the eldest in the family; or 3) Have a desire to continue their education beyond high school. For further information you may contact the program coordinator, Leslie Ramirez, at CENTER FOR PRE-COLLEGIATE AND ACADEMIC OUTREACH PROGRAMS Campus Box DC147 PO Box Larimer St North Classroom #4032 Denver, CO Phone Fax pcmsap@ucdenver.edu

2 RESUMEN DEL PROGRAMA NOMBRE DEL PROGRAMA: * * * * * * * * * * * * * * * * * * * * * * * * * * * * El programa académico de en la Universidad de Colorado Denver es un programa de realizamiento académico. El programa es diseñado para preparar adecuadamente a estudiantes de primera generación con destino universitario en los grados 7 y 8 para inscribirse en un currículo preparatorio universitario y completar con éxito su carrera de escuela secundaria. El Programa ofrece la oportunidad de participar en una amplia variedad de actividades pre-colegiales a los estudiantes durante el año académico. El componente académico ofrecerá sábados académicos mensuales consistiendo de: habilidades de estudios básicos (es decir estrategias para tomar notas efectivas, preparación para exámenes, escuchar efectivamente, etc.). Los estudiantes serán expuestos a: instrucciones académicas supleméntales; desarrollo de habilidades comunicativas; exploración de carreras; preparación para la transición a la secundaria; talleres colaborativos de padres, y una variedad de actividades culturales. El Program sirve como un precursor al Pre-Collegiate Development Program para estudiantes en la secundaria. Los estudiantes quienes exitosamente completan el Programa con un promedio de grado (GPA) de 2.75 o mejor, serán admitidos al programa de secundaria al comienzo de su 9 grado. Una vez al mes los sábados, los estudiantes participaran en las academias en el Campus Auraria. Estas academias se llevaran a cabo 8:00 a.m.-12:00 p.m., y todos los estudiantes estarán obligados a asistir. Ida y vuelta billete de autobús RTD y el almuerzo será dado a los participantes del Programa. El programa de las Academias para el semestre de primavera del 2015 es el siguiente Fecha: Dic. 13 Enero 3 Feb. 7 Mar. 7 Abril 11 Abril TBD Academias del Sábado: Orientación para Nuevos Estudiantes/Padres Habilidades Interpersonales Examen Explore La Resolución de Conflictos Carreras de la Salud La Raza Conferencia de Liderazgo Juvenil El criterio de selección es lo siguiente: Estudiantes DEBEN: 1) Asistir a una escuela en nuestro objetivo. 2) Ser estudiante de primera generación a la universidad (ninguno de sus padres ya sea naturales o adoptivos han recibido un bachillerato). 3) Tener un promedio de calificaciones (GPA) de En adición, el estudiante DEBE también satisfacer uno o más de los siguientes requisitos: 1) Ser miembro de una familia con un solo padre/madre 2) Ser el mayor hijo/a en la familia; o 3) Tener el deseo de continuar con su educación más allá de la secundaria. Para más información, contáctese al coordinador del Programa, Leslie Ramirez, al CENTER FOR PRE-COLLEGIATE AND ACADEMIC OUTREACH PROGRAMS Campus Box DC147 PO Box Larimer St North Classroom #4032 Denver, CO Phone Fax pcmsap@ucdenver.edu

3 APPLICATION FOR PROGRAM PARTICIPATION Application will only be reviewed if completely filled out. STUDENT GENERAL INFORMATION NAME: MAILING ADDRESS: LAST FIRST MIDDLE STREET OR P.O. BOX CITY STATE ZIP PHONE: ADDRESS: PARENT CELL: PARENT BIRTH DATE: SOCIAL SECURITY NUMBER: GENDER: ( ) MALE ( ) FEMALE ETHNICITY (check all that apply): ( ) AFRICAN AMERICAN ( ) ASIAN ( ) LATINO ( ) NATIVE AMERICAN ( ) WHITE ( ) OTHER CITIZENSHIP: ( ) U.S. CITIZEN ( ) LEGAL PERMANENT RESIDENT ( ) OTHER PRIMARY LANGUAGE SPOKEN AT HOME: ( ) ENGLISH ( ) SPANISH ( ) OTHER: # OF SIBLINGS (BROTHERS/SISTERS): # OF SIBLINGS IN COLLEGE: ARE YOU THE ELDEST CHILD IN YOUR FAMILY? ( ) YES ( ) NO DO YOU QUALIFY FOR FREE/REDUCED LUNCH: ( ) YES ( ) NO INFORMATION OF PARENT(S) OR GUARDIAN(S) STUDENT RESIDES WITH NAMES OF PARENT(S) OR GUARDIANS(S): FATHER OR MALE GUARDIAN: MOTHER OR FEMALE GUARDIAN: ARE YOUR PARENTS DIVORCED OR SEPARATED? ( ) YES ( ) NO WHOM DO YOU LIVE WITH? ( ) BOTH PARENTS ( ) MOTHER ( ) FATHER ( ) OTHER: ARE THE MAILING ADDRESS AND PHONE NUMBER THE SAME AS THE STUDENT'S? ( ) YES ( ) NO IF NOT, WHAT IS THE PARENT(S) OR GUARDIAN(S) ADDRESS AND PHONE NUMBER? STREET OR P.O. BOX CITY STATE ZIP PHONE NUMBER TOTAL # IN THE FAMILY: # IN HOUSEHOLD: # OF CHILDREN IN COLLEGE: HAS EITHER PARENT RECEIVED A BACHELOR'S DEGREE FROM A U.S. COLLEGE OR UNIVERSITY? FATHER: ( ) YES ( ) NO MOTHER: ( ) YES ( ) NO HIGHEST GRADE COMPLETED BY FATHER BY MOTHER OCCUPATION: FATHER MOTHER CENTER FOR PRE-COLLEGIATE AND ACADEMIC OUTREACH PROGRAMS Campus Box DC147 PO Box Larimer St North Classroom #4032 Denver, CO Phone Fax pcmsap@ucdenver.edu

4 STUDENT'S SCHOOL INFORMATION NAME OF THE MIDDLE SCHOOL PRESENTLY ATTENDING: GRADE: ( ) 7 TH ( ) 8 TH WHAT HIGH SCHOOL DO YOU PLAN TO ATTEND? FIELDS OF INTEREST WHAT SUBJECTS DO YOU DO WELL IN? WHY? WHAT SUBJECTS ARE HARD FOR YOU? WHY? WHAT ACTIVITIES DO YOU PARTICIPATE IN AFTER SCHOOL? ARE YOU APPLYING TO OR HAVE BEEN ACCEPTED TO ANOTHER PRE-COLLEGIATE TYPE PROGRAM? ( ) YES ( ) NO. IF YES WHICH PROGRAM: THE ABOVE INFORMATION IS TRUE TO THE BEST OF MY KNOWLEDGE STUDENT'S SIGNATURE DATE SIGNED PARENT(S) OR LEGAL GUARDIAN(S) SIGNATURE DATE SIGNED

5 University of Colorado Denver Teacher Recommendation Form (Recommendation from an academic teacher) Student School Grade Level Teacher Subject/Level Grade Currently Earning TO THE TEACHER: The above student is applying to the at the University of Colorado Denver. This program is designed to ensure that more first-generation students are provided with opportunities to pursue higher education. Please complete this questionnaire and add any additional comments that you feel would benefit this student in his/her application process. We appreciate your time and effort in completing this form. LEARNING CHARACTERISTICS CHECK THE COLUMN WHICH BEST COMMENTS DESCRIBES THE STUDENT 1. Does the student complete homework or other outside assignments on time? 2. Does the student stay on task even if the assignment is difficult? 3. Does the student take the initiative for his/ her own learning? 4. Is the student s oral and written communication mature and grammatically correct? MOTIVATIONAL QUALITIES 1. Is the student enthusiastic about learning? 2. Does the student handle outside responsibilities as well as school demands? 3. Is the student self-confident, emotionally secure and self-assertive? 4. Does this student receive reinforcement from family in respect to his/her education? 5. Does the student have good time management and study skills? TEACHER RECOMMENDATION: Highly recommend ( ) Recommend ( ) Recommend with reservations ( ) Cannot Recommend ( ) (For additional comments please use reverse side.) Teacher Signature Date COPYRIGHT 2000 by the Board of Regent/University of Colorado

6 University of Colorado Denver Teacher Recommendation Form (Recommendation from an academic teacher) Student School Grade Level Teacher Subject/Level Grade Currently Earning TO THE TEACHER: The above student is applying to the at the University of Colorado Denver. This program is designed to ensure that more first-generation students are provided with opportunities to pursue higher education. Please complete this questionnaire and add any additional comments that you feel would benefit this student in his/her application process. We appreciate your time and effort in completing this form. LEARNING CHARACTERISTICS CHECK THE COLUMN WHICH BEST COMMENTS DESCRIBES THE STUDENT 1. Does the student complete homework or other outside assignments on time? 2. Does the student stay on task even if the assignment is difficult? 3. Does the student take the initiative for his/ her own learning? 4. Is the student s oral and written communication mature and grammatically correct? MOTIVATIONAL QUALITIES 1. Is the student enthusiastic about learning? 2. Does the student handle outside responsibilities as well as school demands? 3. Is the student self-confident, emotionally secure and self-assertive? 4. Does this student receive reinforcement from family in respect to his/her education? 5. Does the student have good time management and study skills? TEACHER RECOMMENDATION: Highly recommend ( ) Recommend ( ) Recommend with reservations ( ) Cannot Recommend ( ) (For additional comments please use reverse side.) Teacher Signature Date COPYRIGHT 2000 by the Board of Regent/University of Colorado

7 University of Colorado Denver Counselor Recommendation Form Student: School: Counselor: Grade Level: Cumulative G.P.A.: TO THE COUNSELOR: The above student is applying to the at the University of Colorado Denver. This program is designed to ensure that more first-generation students are provided with opportunities to pursue higher education. Please complete this questionnaire and add any additional comments that you feel would benefit this student in his/her application process. We appreciate your time and effort in completing this form. Check or list outstanding achievement in Academic area(s) and extra-curricular activities Math ( ) Science ( ) Social Science ( ) English ( ) Other ( ) Extra-curricular area (1) (2) (3) Report number of credit hours completed for the following academic areas: Math Science Social Science English Other Attendance Good 0-3 ( ) Fair 4-7 ( ) Poor 7+ ( ) Career/Higher Education Aspirations 1. Does the student demonstrate an interest in pursuing higher education opportunities? 2. Does the student receive positive reinforcement from family regarding his/her education? 3. Does the student respond well to pressure, tight schedules, and heavy pressure demands? CHECK THE COLUMN WHICH BEST DESCRIBES THE STUDENT COMMENTS: Interpersonal Relationships 1. Does the student relate to his/her peers in a social situation? 2. Does the student communicate his/her needs effectively? 3. Does the student demonstrate leadership abilities? COUNSELOR RECOMMENDATION: Highly recommend ( ) Recommend ( ) Recommend with reservations ( ) Cannot Recommend ( ) (Please include an unofficial transcript with this form) Counselor Signature Date COPYRIGHT 2000 by the Board of Regent/University of Colorado