Bridges-2015-Summer-Program-Application

2015 SUMMER PROGRAM APPLICATION GUIDELINES AND INSTRUCTIONS
Program Overview:
The Bridges to Success Summer Program provides you with an opportunity to begin your college-level work in the summer
prior to full-time degree-seeking enrollment at Valencia College in the fall. If you are selected for the program, you will register
and attend courses from June 23, 2015 to July 31, 2015. Bridges students receive individualized personal attention from
Valencia’s faculty and staff. These individuals are dedicated to assisting students in making a successful transition from
high school to college and will help build leadership skills through community service and extra curricular activities.
Upon successful completion of the Bridges to Success Summer Program, you will become a Bridges to Success Achievers
Scholar in the Fall 2015. Bridges Achievers Scholars receive a renewable in-state full-tuition scholarship and book stipend
that will be coordinated with financial aid to cover the full cost of attending Valencia College.
Eligibility:
Class of 2015 high school graduates from Orange and Osceola Counties are invited to apply for the Bridges to Success Summer
Program. Special consideration is given to students with financial need and/or documented risk factors that may impede entry
into college.
All these items are due on or before January 28, 2015 by 5:00 p.m.
Application Checklist:
 Submit a Valencia Application for Admissions ($35) online at valenciacollege.edu/admissions for the
2015 Summer Term.
 Submit the 2015 Bridges to Success Summer Program application.
 Complete Florida Residency online at valenciacollege.edu/admissions
 Attach unofficial high school transcript.
 Attach two recommendation forms to the application in a sealed envelope.
 Complete all three essay questions (include your name & Valencia ID Number on essay).
Financial Aid Checklist: (Please print confirmation pages and attach them to your application)
 Submit the 2014-2015 FAFSA (Free Application for Federal Student Aid) online at www.fafsa.ed.gov
 Complete the 2015-2016 FAFSA (Free Application for Federal Student Aid) online at www.fafsa.ed.gov
Assessment Checklist:
 Submit your PERT (reading, math, writing) scores to Valencia’s Assessment Office;

–OR–
Submit ACT/SAT scores that are college level (send directly to Valencia College).
If you are accepted into the Bridges to Success Program, you will be required to attend:
 Mandatory Bridges New Student Orientation
 Mandatory Bridges Program Service Learning Project
 Mandatory Parent Orientation
Final High School Transcript:
 Submit final high school transcript indicating date of graduation from high school.
Please note that all items must be satisfied by the due date in order to be eligible for acceptance into the Bridges to Success
Summer Program. Incomplete application packets will NOT be accepted. NO EXCEPTIONS.
HELPFUL HINTS AND INFORMATION
 Complete all sections of application. Write N/A if the information does not apply to you.
 Pay your Valencia College application fee of $35 before the Bridges to Success (BTS) application deadline.
 Have someone proofread your essay before submitting it with your application and make corrections.
 DO NOT wait to take PERT Assessment Sections (Reading, Writing, Math) on the application deadline date
or your scores will not show up in the system.
 BTS requires that you submit all sections of the PERT score, or you can submit your ACT/SAT scores but
they MUST be college level or you will be required to take the PERT.
o ACT Reading 19 or higher
o ACT Writing 17 or higher
o ACT Math 19 or higher
o SAT Reading 440 or higher
o SAT Writing 440 or higher
o SAT Math 440 or higher
 Submit all community service hours to school counselor well in advance and be sure they are on
your unofficial transcript.
 Check the BTS website for a list of Community Partnership Organizations you may be a part of.
 Recommendation forms should be completed by someone who knows you well and can write about
your accomplishments.
 Set up your Valencia ATLAS account so you can receive notification about your application status.
 Application decisions are generally finalized in April 2015.
 All requests for application status should be made via email to tcarter27@valenciacollege.edu using
your Valencia ATLAS account.
 Orientation dates/times for students accepted into the Bridges to Success Summer Program can be
found on the BTS website valenciacollege.edu/bts
 Having siblings currently in the program or applying does not guarantee admission into the BTS program.
 When submitting your application to the Answer Center, be sure to request an application
submission receipt.
RELEASE OF INFORMATION
Please type or print in blue/black ink all information requested. Complete entire application.
2015 SUMMER PROGRAM APPLICATION
DATE
FOR OFFICE USE ONLY
Date Received:
GENDER
 Male  Female
NAME
Entered ROANYUD:
DATE OF BIRTH
VID:
SOCIAL SECURITY NUMBER
VALENCIA ID#
EMAIL ADDRESS
High School Name:Expected Graduation Date:
Native Language:Major/Program of Study:
Race/Ethnicity:
Please Check Assessments Taken (College Level Scores):
Date you completed 2014-2015 FAFSA:
Did you pass the FCAT Reading?
 Yes  No
 ACT  SAT  PERT Reading  PERT Math  PERT Writing
Date you completed 2015-2016 FAFSA:
Campus preference (Summer Term Only)  Osceola  West  East
Personal Information
HOME PHONE
HOME ADDRESS
CELL PHONE
CITY
STATE
ZIP CODE
Emergency Contact
NAME
HOME PHONE
HOME ADDRESS
CELL PHONE
CITY
STATE
Please list any extracurricular or community service activities in which you have participated:
(please attach additional pages if necessary)
Community service hours must be documented on high school transcript
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ZIP CODE
Please indicate by checking below risk-factors that may impede your access to a higher education.
 First generation college student
 English as a second language
 Known disability
 Teen parent
 Low parent involvement/support
 Attend low performing school as indicated by DOE
 Ward of state/orphan
 Homelessness
 DACA (Deferred Action for Childhood Arrivals)
 Single parent home
 Disabled or severely ill parent; caretaker or sibling
 Unemployment of parent/guardian
 Qualify for free or reduced lunch
 Incarcerated parent
 Foster child
 Juvenile incarceration
 Undocumented residency status
 Other
Please note that only US Citizens and Permanent Resident Aliens are eligible for this scholarship, and that the
availability of other scholarship and financial aid funds may be limited as well.
Please indicate your participation in the pre-collegiate programs listed below (list the month/year):
College Reach-Out Program Upward Bound
*Dual Enrollment If yes, how many college credit hours completed?
*Students with more than 6 completed dual enrollment credit hours will not be eligible for Bridges to Success.
**Advanced Placement credits
AVID/TRIO/ELEVATE **Students with more than 12 complete advanced placement credits will not be eligible for Bridges to Success.
Do you have any sibling(s) who is/are currently in the Bridges Program? If yes, name:
Do you have sibling(s) who is/are applying for the 2015 Summer Program? If yes, name:
Are you supported by any Community Partnership Organizations? If yes, name:
Personal Essay: (Include your name and VID on essay)
In 500 words or more please answer the following three questions in one essay:
1. Why do you want to participate in the Bridges Summer Program?
2. Describe a personal challenge or adversity you’ve experienced and how you were able to overcome that obstacle
(provide specific steps that were necessary).
3. How will the Bridges program help you in achieving your educational and career goals?
Notification of Social Security Number Collection and Usage
In compliance with FL Statute 119.071(5), this document serves to notify you of the purpose for the collection and usage of
your Social Security Number (SSN). Valencia College (Valencia) collects and uses your SSN only for the following purposes
in performance of the College’s duties and responsibilities. To protect your identity, Valencia will secure your SSN from
unauthorized access, strictly prohibits the release of your SSN to unauthorized parties in accordance with state and federal
law, and assigns you a unique student/employee identification number. This unique ID number is used for all associated
employment and educational purposes at Valencia.
Deadline: January 28, 2015 by 5:00 p.m.
Please follow the Application Checklist found in the 2015 Summer Program Guidelines
for additional requirements and deadlines.
COMPLETED APPLICATION PACKETS MUST be postmarked by the deadline or dropped off at any Answer Center
Valencia College
Bridges to Success
1800 S. Kirkman Rd.
Mail Code 4-25
Orlando, FL 32811
For more information call 407-582-1395 or Valencia College Answer Centers East, Osceola, or West Campus.
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VALENCIA BRIDGES TO SUCCESS RELEASE OF INFORMATION
I hereby authorize
(NAME OF HIGH SCHOOL)
to release a transcript of grades earned, credits received, aptitude and achievement test scores, and other information relating to
the student named below. In addition, I give Bridges to Success authority to release information related to my acceptance into the
program to my school administration.
Name of Student
Social Security #
Release the following information to Valencia:
3 School Name
3 Ethnic Code
3 ESE Information
3 Gender
3 Address
3 Social Security Number
3 Grade Point Average
3 Telephone Number
3 Class Ranking
SIGNATURE OF STUDENT
TODAY’S DATE
SIGNATURE OF PARENT
(Parent signature required on application if student is under 18)
TODAY’S DATE
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SUMMER 2015
STUDENT RECOMMENDATION FORM
To be completed by the Applicant:
Please complete the information below and then provide your teacher, guidance counselor, principal, or community service supervisor
with this form along with an envelope. One recommendation form should be completed by your teacher, guidance counselor, or principal.
The second recommendation form should be completed by your community service or volunteer supervisor. The applicant should mail
the two recommendation forms received from the recommenders in sealed envelopes at the same time the application is submitted.
STUDENT INFORMATION (TO BE COMPLETED BY APPLICANT)
Name
Date
Address
Phone
City/State/Zip Email
High School
The Family Educational Privacy Act of 1974 and its amendments guarantee students access to educational records
concerning them. Students are permitted access to recommendations. The following indicates the wish of the applicant
regarding this recommendation:


I waive my right of access to this recommendation
I do NOT waive my right of access to this recommendation
Applicant’s Signature:
Date:
To be completed by the Recommender:
We would appreciate your candid evaluation of the student named above to aid us in evaluating his/her candidacy for acceptance into
the Bridges to Success Summer Program. Please place your recommendation in an envelope, seal it, and sign your name twice over
the seal. Please give the student the envelope to be returned with their completed application packet.
RATINGS
Academic achievement
5 = Excellent
4 = Above
Average
3 = Average
2 = Below
Average
1 = No
Information
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Comments
Leadership potential
Comments
Motivation/initiative
Comments
Communicates effectively: written
Comments
Communicates effectively: orally
Comments
Works and relates well with others
Comments
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RATINGS (Cont.)
5 = Excellent
4 = Above
Average
3 = Average
2 = Below
Average
1 = No
Information
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Learns from past experiences
Comments
Reaction to setbacks
Comments
Approaches school with seriousness
Comments
Accepts responsibility
Comments
Expresses opinions and disagreements
in a mature manner
Comments
Overall Rating
EVALUATION
How long and in what capacity have you known this applicant? Please indicate in the statement an assessment of
his or her strengths and weaknesses.
Name: (Please Print)
Position/Title:
Phone:
School/Company:
Email:
Signature:
Date:
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SUMMER 2015
STUDENT RECOMMENDATION FORM
To be completed by the Applicant:
Please complete the information below and then provide your teacher, guidance counselor, principal, or community service supervisor
with this form along with an envelope. One recommendation form should be completed by your teacher, guidance counselor, or principal.
The second recommendation form should be completed by your community service or volunteer supervisor. The applicant should mail
the two recommendation forms received from the recommenders in sealed envelopes at the same time the application is submitted.
STUDENT INFORMATION (TO BE COMPLETED BY APPLICANT)
Name
Date
Address
Phone
City/State/Zip Email
High School
The Family Educational Privacy Act of 1974 and its amendments guarantee students access to educational records
concerning them. Students are permitted access to recommendations. The following indicates the wish of the applicant
regarding this recommendation:


I waive my right of access to this recommendation
I do NOT waive my right of access to this recommendation
Applicant’s Signature:
Date:
To be completed by the Recommender:
We would appreciate your candid evaluation of the student named above to aid us in evaluating his/her candidacy for acceptance into
the Bridges to Success Summer Program. Please place your recommendation in an envelope, seal it, and sign your name twice over
the seal. Please give the student the envelope to be returned with their completed application packet.
RATINGS
Academic achievement
5 = Excellent
4 = Above
Average
3 = Average
2 = Below
Average
1 = No
Information
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Comments
Leadership potential
Comments
Motivation/initiative
Comments
Communicates effectively: written
Comments
Communicates effectively: orally
Comments
Works and relates well with others
Comments
6 of 7
RATINGS (Cont.)
5 = Excellent
4 = Above
Average
3 = Average
2 = Below
Average
1 = No
Information
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Learns from past experiences
Comments
Reaction to setbacks
Comments
Approaches school with seriousness
Comments
Accepts responsibility
Comments
Expresses opinions and disagreements
in a mature manner
Comments
Overall Rating
EVALUATION
How long and in what capacity have you known this applicant? Please indicate in the statement an assessment of
his or her strengths and weaknesses.
Name: (Please Print)
Position/Title:
Phone:
School/Company:
Email:
Signature:
Date:
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