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      GEARUP SCORES!  Gaining Early Awareness and Readiness for Undergraduate Programs      Student Name: ______________________________________________________________________  (Please Print Clearly)        School: ______________________________________________________   Grade: _______________    Commitment/Consent Form    GEARUP (Gaining Early Awareness and Readiness for Undergraduate Programs) is a U.S. Department of  Education program designed to prepare students for college.    What types of services will we provide over the next five years?  • Academic support,  • Summer enrichment  programs and activities,  • Educational field trips,  • Test preparation (OAT, OGT, SAT, ACT),  • Academic and college counseling and advising,  • College tours and college fairs,  • College application and financial aid workshops,  • Mentoring, and  • Parent seminars and workshops.    Student and Parent Commitment By signing below, we agree to:  • Take full advantage of GEARUP activities, programs, and services.  • Grant permission for GEARUP staff to view my student’s grades, test scores, and other records.  • Grant permission to provide my student transportation to/from GEARUP activities and events.  • Grant permission to use my student’s images on the GEARUP website and in promotional or                 publicity materials.        Student Signature: ___________________________________________________________________                                            Parent Name: ___________________________________  Phone:  _____________________________  (Please Print Clearly)          Parent Signature: ____________________________________________    Date: __________________                               Mailing Address: ____________________________________________       Zip Code:  ______________                                                                                                                                                                 Alternate Contact Number(s):  1. __________________________    2.  __________________________     Emergency Contact: ____________________________________         Phone:  ____________________  For more information about GEARUP, please call Bob Suess at 556‐4184   or visit our website at www.uc.edu/gearup/    RETURN COMPLETED FORM TO GEARUP STAFF AT YOUR SCHOOL 

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