Strengthening Raizes y Culturas

Transcription

1 The Program The College Assistance Migrant Program () at the is federally funded through the U.S. Department of Education, Office of Migrant Education. The residential program was established to identify, recruit, admit, and enroll migrant and seasonal farm worker students and provide them academic, social, and financial support to enable them to complete their first year of college. offers participants: financial assistance, academic advisement, tutoring/mentoring, workshops, and social/cultural activities. Eligibility Student or his/her parent(s) or guardian(s) must have spent a minimum of 75 days during the past 24 months as a migrant or seasonal farm-worker; OR The person must have participated or be eligible to participate in the Employment and Training Administration, Department of Labor Workforce Investment Act (WIA), Migrant and Seasonal Farm- Worker Programs; AND Student must have filed a FASFA form (Free Application for Federal Student Aid) and demonstrate a financial need. Additionally, student must be admitted and enrolled full-time (min 12 hrs) at the and not be beyond the first academic year of a program of study. Program Requirements Participants agree to attend workshops, tutor/mentor meetings, academic advising meetings, and social and cultural enrichment activities offered by. Participant Benefits Supplemental Financial Assistance Participation Stipend Textbook Program One-on-One Academic Advisement Personal Tutoring STEM, Study Skills and Development Workshops Cultural Enrichment Activities Freshman Seminar If you meet the eligibility requirements and would like to apply for please submit the application to: College Assistance Migrant Program 1157 County Road 110 Ranchos de Taos, NM or fax to Physical Location: 114 Civic Plaza Drive, Taos, NM For more information call us at

2 STUDENT APPLICATION CHECK LIST Future Student: Strengthening Raizes y Culturas County Road 110 Ranchos de Taos, NM Phone # Fax: Below is a list of the information you will need in order to process your application. Please mail or fax all information. In the event that the application is faxed, all original forms must be mailed in as well. If you have any questions regarding the application, please contact the UNM program at (575) or to camp@unm.edu application: Please complete the following information on the application General Information Birth Date Address/Phone High School Graduation or GED Completion Dates Work History The Employer Verification form, or a copy of your Certificate of Eligibility for Chapter I Migrant Education Program, or a copy of your WIA 167 Certificate Please also include the following with your application Copy of High School transcript or GED scores (if you graduated from a GED Program) Personal Statement/Essay (a minimum of one and half pages) o State your goals o Background o Obstacles overcome 1 Recommendation Letter You may use the recommendation form provided A copy of the FAFSA SAR (Student Aid Report)

3 STUDENT APPLICATION Name: Social Security #: Sex: Age: Birth date: Address: City: State: Zip: County: Home Phone: Cell Phone: Citizenship: U.S. Citizen Permanent Resident No. Temporary Resident Marital Status: Single Married Divorced Separated/Widowed: The University of New Mexico Taos is required by Federal law to request this information for statistical reporting purposes. Your response is voluntary. Do you consider yourself to be Hispanic/Latino/a? Yes No In addition, select one or more of the following racial categories to describe yourself: American Indian or Alaska Native Tribal affiliation(s): Asian Black or African American Native Hawaiian or Pacific Islander White In case of emergency, please notify: Phone: ( ) - ELIGIBILITY To qualify for, you must have participated in one of the following within the last 24 months: Have you or your parents worked as seasonal/ migrant farm workers for at least 75 days? Are you a participant of a Chapter I Migrant Program? Do you qualify for the WIA 167 Program? HIGH SCHOOL GRADUATION/GED COMPLETION Date of High School Graduation: or date of GED completion: High School: GED Program: Do you qualify for a Pell grant? Have you applied for Admissions to the STUDENT-PARENT TRANSCRIPT RELEASE AUTHORIZATION You have my consent to release my son s/daughter s grades and test scores to the Director of the program. (If you are 18 years or older you do not need a parent signature) Student s Signature Date / / Parent s Signature Date / /

4 **If you do not have a Certificate of Eligibility or qualify under the WIA 167 program** PLEASE COMPLETE THIS FORM WORK HISTORY (Please give an approximate start and end date if you are not sure of the dates) Father s/guardian Name: Father s Employment History for the last two years Last Year s Income: Employer City Type of Work Start Date End Date Total Days Mother s/guardian Name: Mother s Employment History for the last two years Last year s Income: Employer City Type of Work Start Date End Date Total Days Applicant s Name: Applicant s Employment History for the last two years Last year s Income: Employer City Type of Work Start Date End Date Total Days MEDICAL HISTORY Primary Doctor: Address: Phone No.: ( ) - Known Allergies: Medication: Special Diet: Comments: I certify that the information on this application is true. If I am accepted to the University of New Mexico-Taos, I agree to follow all rules and regulations established by the program. I agree to participate in the academic support provided by to assist me in completing my freshmen year at UNM-Taos. Student s Signature Parent s Signature (If under 18 years of age) Date Date

5 RECOMMENDATION TO: School Counselor/Principal/Teacher/Advisor Strengthening Raizes y Culturas County Road 110 Ranchos de Taos, NM Phone # Fax: Re: (Student s Name) This student has applied to participate in the University of New Mexico Program. A counselor or other appropriate high school staff must complete the information requested below before the application can be considered. Please fill in the form, adding any appropriate comments as needed. The evaluation below will assist in determination of the student s potential to succeed in a four-year academic degree program. Student s GPA: Student s Attendance: (Excel, Good, Fair, Poor) ACADEMIC PREPARATION Strong Good Average Weak Very Weak Study Skills Mathematics Writing Reading PERSONAL QUALITIES Self-Motivated Self Discipline Initiative Enthusiasm Please elaborate on qualities, intangibles & values the student will bring to the university and. (please use a separate sheet of paper if the space is not sufficient) Signature: Date: Title: Name of School or Agency:

6 EMPLOYER VERIFICATION Agricultural work will be verified through this form. If you would like to include more information please attach a letter detailing the type of work performed. To: Employer (Employer s name) ( ) - (Employer s address) (City) (State) (Zip) (Telephone) Re: Re: (Applicant s Name) (Employee s Name if different from applicant) This Student has applied to participate in the College Assistance Migrant Program at the University of New Mexico-Taos. In order to be eligible, the student or one of his/her parents must have worked as seasonal/migrant farm worker for at least 75 days within the last 24 months. Therefore, we would like to verify if you have employed this student or one of his/her parents as a seasonal or migrant farm worker. Seasonal farm worker: is a person whose primary employment is farm work (related to crops, dairy products, poultry, livestock, tree harvesting, or fish farms) on a temporary basis. Migrant farm worker: is seasonal farm worker whose employment requires travel that keeps him/her from returning to their permanent home within the same day. Type of Work Approx. Start Date Month/Year Approx. End Date Month/Year Total Days PAYMENT (hourly wage or subsistence (payment in crops): In the space below please be specific as to what type of work was performed. Signature of Employer/Supervisor Date