2017 Admission Application

Transcription

1 2017 Admission Application DEAR PARENT OR GUARDIAN: What would you say if we were to offer your child over $10,000 worth of free services to help him or her succeed in school and get ready for college? Your child has the opportunity to apply for membership in The College Crusade of Rhode Island. Over the past 27 years, The College Crusade has helped more than 20,000 children just like yours succeed in school. We have also awarded almost $33 million in college scholarships to more than 4,200 eligible Crusaders. Your child, too, may qualify for a College Crusade Scholarship. Membership criteria: Only children from low-income families can apply for membership in The College Crusade. In addition, children must: Attend 6 th grade at a public school or public charter school in Central Falls, Pawtucket, Providence or Woonsocket in the fall of 2017 Be committed to working hard in school and earning good grades Attend all our required programs and be willing to prepare for college We begin helping your child in 6th grade and continue our support though high school graduation as well as postsecondary support. Our programs and services provide the advantages your child needs to get ready for college, and our caring staff of College Crusade Advisors offers guidance along the way. Your child will participate in our after-school clubs, study skills workshops, leadership development and career exploration activities, college visits, college application workshops, SAT preparation courses, and much more. Best of all, everything is absolutely free. We strongly encourage you to take advantage of this exceptional opportunity to increase your child s educational success. To learn more, visit or call our Admissions Department at ext 111. Your child s enrollment in the 2017 College Crusade class is subject to adequate funding. Sincerely, William D. Formicola Senior Vice President for Operations Please complete our application for admission and return it to us as soon as possible in the envelope provided. Application instructions are on page 3. Space is limited. Apply now! It is a mandatory requirement that all qualified applicants attend our four-day study skills workshop, and parents must attend an orientation workshop. All requirements must be met prior to your child being admitted to The College Crusade. The College Crusade of Rhode Island 134 Thurbers Avenue, Providence, RI Phone Fax Rev September 2016

2 2017 Application Instructions For 2017 Admissions At The College Crusade of Rhode Island, we believe that family involvement and influence are important factors that help ensure greater success for our students. We need your assistance as you and your child begin the application process. These application instructions tell you what you must do before we can reach a decision on your child s application. Parents are responsible to ensure that the application is complete and all necessary steps are met. The College Crusade is not responsible for ensuring that the student has completed the application process. Please note that all of the following are necessary to be eligible and to have a completed application: Current enrollment as a 5th grader with plans to attend 6th grade at a public or public charter school in Central Falls, Pawtucket, Providence, or Woonsocket in the fall of Proof of residency (utility bill, check stub, etc.). Proof of permanent residency or U.S. citizenship. Please provide a copy of the student s Social Security card. AND ANY ONE OF THE FOLLOWING: A copy of the student s U.S. Birth Certificate or a copy of the U.S. Passport A copy of the student s Alien ID Card Proof of Free or Reduced Lunch status. Please provide a copy of the letter you received from the RI Department of Education Free/Reduced Lunch list or a copy of your SNAP letter. Personal Information and Essay Recommendation Form (completed by a caring adult who is not a parent, guardian, or relative). PARCC standardized test result (Please provide a copy of the student s most recent PARCC standardized test result. Contact your child s school to obtain a copy). Report Card Please provide a copy of your student s 5 th grade report card for the 2016/17 school year. (Contact your child s school to obtain a copy). When applications are complete, all students must attend 4 days of study skills as part of the enrollment requirements. The final step will require that parents attend an orientation and complete the membership and scholarship agreement. Note: Please be certain that all forms are filled out completely and all appropriate forms are properly signed. Your child s application will not be processed until all the materials listed above are received. For more information, contact The College Crusade of Rhode Island s Admissions Department at ext 111. Rev September 2016

3 2017 Personal Information and Essay STUDENT INFORMATION Please Print in Ink Name Birth date / / Last name Middle initial First name Mo Day Year Address Street / Apt. # City Zip Gender: Male Female Student (please print) Current grade in school Current school Fall 2017 school (if known) Student s Social Security #: Social Security Number - - Student s Citizenship or Permanent Residency Status (please check ONE box) Citizen of the United States An alien admitted for permanent residence Alien Number A Please complete other side PARENT/GUARDIAN INFORMATION Please Print in Ink Mother s / Guardian s name Home phone ( ) - Cell phone ( ) - Father s / Guardian s name Home phone ( ) - Cell phone ( ) - Please sign here Information regarding your child s application will be held in the strictest confidence. Your child s enrollment in the 2017 College Crusade class is subject to adequate funding. By signing this agreement, I state that I have answered all questions honestly and to the best of my ability. I understand that this application does not guarantee acceptance to The College Crusade of Rhode Island. I also give The College Crusade permission to obtain copies of my child s school records, state academic scores, and school lunch eligibility records Note: Collection of school administrative data from schools, districts, or state offices may require secure release of student identifiers (names, dates of birth, social security numbers) for linkage or matching purposes. Student s name (please print) Parent/Guardian name (please print) Student s signature Date Parent/Guardian signature Date The College Crusade of Rhode Island 134 Thurbers Avenue, Providence, RI Phone Fax

4 STUDENT INFORMATION (continued) Please Print in Ink Student s Racial/Ethnic Background (please answer BOTH questions): What is your ethnicity? Hispanic or Latino Not Hispanic or Latino What is your race? White Black or African American Asian (mark one or more) American Indian or Alaska Native Native Hawaiian or Other Pacific Islander Do you have any special needs? (please circle ALL that apply) Physical Educational Emotional Other Please explain Is English primarily spoken at home? Yes No If no, what primary language is spoken? If Spanish is the primary language spoken at home, do you prefer to receive communications in Spanish? Yes No Do you have a home computer? Yes No Do you have Internet access? Yes No STUDENT S ESSAY To be completed by the student Please use the following space to write a paragraph about: What do you think it means to be a Crusader? What is your goal or hope for the future? Why do you want to be a Crusader? Please print or attach a typewritten sheet. Rev August 2016

5 FOR THE STUDENT Please print your name in the space provided. Give this form to a caring adult, such as a teacher, coach, community member, church member, or minister who has been involved in your life, and ask them to fill it out completely. PLEASE TYPE OR PRINT IN INK 2017 Recommendation Form Student s name Last name Middle initial First name For the Reference Cannot be completed by parent, guardian, or relative. Para Referencia No puede ser completeda por padres, guardian, o familiar. Thank you for providing a reference for this student who is applying to The College Crusade of Rhode Island. Our program will set high expectations and provide support to the applicant to meet their goal to complete college. Accordingly, we are grateful for your assistance, value your comments, and assure you that your feedback will be kept confidential. For more information about The College Crusade, please visit our website at or call our Admissions Department at ext 111. Name of reference Last name MI First name Jr., etc. Address Street City State Zip Telephone number ( ) - address BACKGROUND INFORMATION Responsibility Maturity Self-confidence Commitment to learning Trustworthiness Teamwork Leadership Respect for others Oral expression Written expression Intellectual curiosity Emotional stability Desire for a college degree Excellent Good Average Below Average The College Crusade of Rhode Island 134 Thurbers Avenue, Providence, RI Phone Fax Please complete other side

6 3. The College Crusade requires members to participate in our programs. Do you believe this student will commit to attending our required programs? Yes No Comments 4. Can you tell us about the student s academic and/or personal characteristics such as motivation, integrity, initiative, special talents, enthusiasm, and concern for others? Please feel free to attach a separate document if you need more space. 4. May we contact you for more information regarding this student? Yes No Your signature is required. Signature of reference Date PLEASE SEAL YOUR COMPLETED REFERENCE FORM IN AN ENVELOPE BEFORE RETURNING IT TO THE STUDENT. THANK YOU. Rev September 2016