La Casa Student Housing & Resource Center (an initiative of The Resurrection Project)

Transcription

1 College Boot Camp Summer Application 2017

2 La Casa Student Housing & Resource Center (an initiative of The Resurrection Project) 1818 S. Paulina Chicago, IL Tel (312)

3 What is La Casa? La Casa a college success initiative of The Resurrection Project is an innovative model in student housing that surrounds students with many of the benefits and resources of on-campus living plus the added advantage of an on-site Resource Center. The Resource Center provides a wide range of student support services that help students in navigating the complexities of college life and in developing leadership skills. It is a community of students from different universities who live and learn together in order to increase their chance of college success. La Casa is a place where students live, learn, and thrive! What is La Casa College Boot Camp? College Boot Camp is a six-week summer program designed to equip you with tools, resources, and experiences. Whether you want to attend a research university or a liberal arts college, a school in a big city, one in the middle of the state, or a college near your home, you will benefit from this program. personalized college coaching campus visits college search scholarships and financial aid essay writing goal setting Are you a rising 11 th or 12 th grade high school student or a student that is making the transition back to college? Yes No Are you willing to commit to participate in the full-length of this summer program for a duration of 6 weeks (i.e. June 28 to August 4)? Yes No Are you willing to work hard, participate fully in all learning experiences, and contribute to building a positive and supportive community of students? Yes No After completing the La Casa College Boot Camp, are you willing to commit to participating in at least three college and career readiness workshops or events during the academic school year to support your own preparation for the future? Yes No Are you willing to demonstrate a sense of social responsibility through school and community service activities? Yes No Are you willing to submit a recent official high school transcript? Yes No Are you willing to attend the end-of program celebration in the company of a family member and/or mentor? Yes No Application Due Applications will continue to be accepted until all available seats have been assigned Response to Your Application Notification about admission into the program will be ed by Monday, June 5 Start of Program The program is scheduled to begin on Wednesday, June 28 Campus Visits No Class Tours are scheduled to take place each Friday throughout the duration of the program; specific departure and return times will be communicated each start of week The program will not meet on Monday, July 3 and Tuesday, July 4 due to observance of federal holiday Conclusion of Program The program is scheduled to conclude on Friday, August 4 Presentation of Certificates choosing a major career options time management budgeting campus resources test prep Who is eligible to participate? Only students who are willing to commit to the full-length of the program should seek participation in La Casa College Boot Camp. This college readiness experience is designed for students who answer yes to all of the following questions: Important Dates Participation in the full-length of the program is required. Failure to participate may result in disqualification and/or dismissal from La Casa College Boot Camp. Use the following table to find important dates regarding your enrollment in the program. All dates are subject to change. Decision & Review Process The end-of-program celebration is scheduled on Friday, August 4; program participants and at least one family member or mentor are expected to attend The La Casa College Boot Camp application is considered complete when all required signatures and supporting documents are received. Applications are reviewed in date order based on the date your complete application is received. Submit a complete La Casa College Boot Camp Application Submit official high school transcript(s) Submit a complete Contact Form Submit a complete Participant Waiver Form with required signatures

4 College Boot Camp Application, 2017 Student Data (PLEASE PRINT) Name: Address: T-Shirt Size: S M L L L Other: Date of Birth: Gender: Male Female Trans Month / Day / Year Social Security Number (SSN) or Individual Tax Identification Number (ITIN): - - How did you hear about La Casa? (Check all that apply) Friend / Family HS Teacher / Counselor College Staff Event Commuter Center I live in the community Internet Search On-Campus Advertising Other: What languages do you speak? List them. Education Which of these statement best describes you? (Choose one) In academic year , I will be an 11 th grade high school student High School that you attend or attended In academic year , I will be a 12 th grade high school student I graduated high school but did not start college. I want to start college in academic year From: Name of High School City / State Month / Year Month / Year GPA Anticipated Graduation Year To: College or University that you have attended From: To: Name of College City / State Month / Year Month / Year GPA Anticipated Graduation Year Aspirations What is the highest level of education that you want to complete? (Choose one) Associate s Degree Bachelor Degree Master s Degree Professional Doctorate Degree (i.e. law, medicine, music, or ministry) Academic Doctorate Degree (i.e. highest award earned for graduate study) What colleges are you considering? Name of College 1 City / State Name of College 3 City / State Name of College 2 City / State Name of College 4 City / State What is your intended program of study when you enroll in college? (If you have not chosen a major or minor, simply designate undecided. ) Major(s): Minor(s):

5 Parent / Guardian 1 Information Name Contact Form (PLEASE PRINT) Address: Highest level of education? (Check one) Middle School Some High School High school or GED completed Some College Certificate Associate Bachelor Master Doctoral Occupation Parent / Guardian 2 Information Name Address: Highest level of education? (Check one) Middle School Some High School High school or GED completed Some College Certificate Associate Bachelor Master Doctoral Occupation Emergency Contact 1 Name Relationship Emergency Contact 2 Name Relationship

6 La Casa College Boot Camp Participant Waivers Participation in Off-site Events I certify that I am the parent, guardian, or custodian of the student listed in this form. I authorize and consent to their participation in weekly field trips to visit college campuses on select dates throughout the duration of the College Boot Camp. School buses and public transportation will be used for transportation to and from campus visits. During hours of field trips, I can be reached at this phone number: _( ) and this . I am aware that with participation in this event there are inherent risks for which The Resurrection Project and 18 th & Paulina Dorm LLC have no control and for which The Resurrection Project and 18 th & Paulina Dorm LLC have no responsibility. If the student engages in activities that are not a part of the off-site event and from which the student may sustain personal injury or other damage to self or property, or cause others to be injured or sustain other damage, including damage to their property, we understand that The Resurrection Project and 18 th & Paulina Dorm LLC and its employees, agents, volunteers or assigns will not be held responsible. We agree to adhere to all of the policies and procedures of The Resurrection Project and 18 th & Paulina Dorm LLC for participation in La Casa College Boot Camp, Chicago jurisdictional laws and ordinances, laws of the State of Illinois and of the United States government. We also agree that if the student fails to follow the above stated policies, procedures, ordinances and laws we will be responsible for any consequences that may result, including dismissal from the program. We have read and understand the above-stated informed consent. Our signatures confirm that we understand and are in agreement with these conditions. Print Student Name Student Signature Date Parent/Legal Guardian Name Relationship to Student Parent/Legal Guardian Signature Date Dismissal By signing below, I allow my dependent who is a under the age of 18 to travel home by him or herself without adult supervision. I understand that the College Boot Camp includes visits to college campuses. A Friday schedule for college visits will be communicated each start of week. Print Student Name Student Signature Date Parent/Legal Guardian Name Relationship to Student Parent/Legal Guardian Signature Date Emergency Clause In the event I cannot be reached in an emergency, I hereby give my permission to employees of The Resurrection Project to secure proper medical care for my dependent as deemed necessary. This permission extends from minor first-aid treatment to hospitalization as deemed necessary. Print Student Name Student Signature Date Parent/Legal Guardian Name Relationship to Student Parent/Legal Guardian Signature Date Media Release I hereby grant permission to record my dependent s likeness and/or voice for use on television, social media, films, radio or printed media to further the aims of The Resurrection Project in related campaigns and printed media, magazine articles, booklets, posters and in any other ways they may see fit. Print Student Applicant s Name Student Applicant s Signature Date Parent/Legal Guardian Name Relationship to Student Parent/Legal Guardian Signature Date Staff Alerts Please list any behavioral problems, diet restrictions, medical conditions, or any other important information for our staff to know.

7 Next Steps The La Casa College Boot Camp application is considered complete when all required signatures and supporting documents are received. Submit a complete La Casa College Boot Camp Application Submit official high school transcript(s) Submit a complete Contact Form Submit a complete Participant Waiver Form with required signatures Applications are reviewed in date order based on the date your complete application is received. Send or deliver your complete application and supporting documents to: LA CASA STUDENT HOUSING & RESOURCE CENTER The Resurrection Project Attn: Director of La Casa 1818 S. Paulina Chicago, Illinois lacasa@resurrectionproject.org Tel (312) Mb

8 La Casa Student Housing & Resource Center 1818 S. Paulina Chicago, Illinois Ph (312)