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Center for Student Success Summer Bridge Program 2017 STUDENT APPLICATION FORM PERSONAL INFORMATION Name ________________________________________________________________________ Date of Birth (mm/dd/yyyy) ______________________________________________________ Phone (Home) __________________________ (Cell) __________________________________ Email ________________________________________________________________________ Mailing Address ________________________________________________________________ Physical Address _______________________________________________________________ HIGH SCHOOL INFORMATION High School ___________________________________________________________________ GPA ________ New SAT Scores: Reading/Writing ________________ Math ________________ ACT Scores: English or English/Writing ____________ Math________________ Counselor’s Name ______________________________________________________________ Counselor’s Signature ___________________________________________________________ ADMISSIONS INFORMATION Have you applied to UVI? Yes No Have you been accepted to UVI? Yes No Do you plan to attend UVI? Yes No If you plan on attending another college, please name that college ________________________ MEDICAL/DISABILITY INFORMATION List chronic or specific medical problems and/or allergies: _____________________________________________________________________________ List medications you are currently taking: ______________________________________________________________________________ EMERGENCY INFORMATION In case of an emergency, list the person(s) to be notified: _______________________________ Relationship to the applicant Phone: (home)____________________(cell)___________________(work)________________ Student’s Signature _____________________________________ Date ___________________ Parent’s/Guardian’s Name ________________________________________________________ Parent’s/Guardian’s Signature ______________________________ Date _________________ Center for Student Success Summer Bridge Program 2017 APPLICATION AND SELECTION PROCESS Phase 1. Application Form and Support Documents Complete and submit application form and other support documentation. Application support documentation includes: a personal statement, a letter of recommendation, and high school transcript. All documents must be submitted together. Criteria for Personal Statement Submit a typed doubled spaced, size 12 fonts, Times New Roman, 300-500 word essay based on the following question: “What goals would I like to accomplish by being a part of the 2017 Summer Bridge program?” Criteria for Letter of Recommendation The applicant’s recommendation is to be from a teacher, guidance counselor, or other school official. The recommendation letter is to share about the applicant’s character, work ethic, and qualities that are deemed important. Criteria for Application Admittance Once the application form and support documents are submitted, the applicant’s information will be reviewed. You will be considered for PART II of the application process if:  Your application is complete and legible  You meet the academic criteria for participating in Bridge (SAT individual scores: Math - above 390 but less than 520, and Reading/Writing – above 400 but less than 560 or ACT individual scores: Math - above 18 but less than 20, and English or English/Writing above 19 but less than 21)  Your personal statement and recommendation is to meet the selected criteria above. (decisions made by the Summer Bridge team are final)  A $25 program fee will be collected once you are accepted into the program Phase 2. Interviews The second stage of the application process requires that you meet with a member of the Summer Bridge team for a 15-minute interview. You will be contacted with the date and time for your interview once we have reviewed your application. The application deadline is Friday, May 12, 2017. Submit completed applications and support documentation by email, mail, or in person to: Albert A. Sheen Campus, St. Croix Ms. Maria Fleming Assistant Director of Center for Student Success/Coordinator of Summer Bridge RR 1 Box 10,000 Kingshill, St. Croix U.S. Virgin Islands 00850-9781 mflemin@uvi.edu St. Thomas Campus Ms. Julie Cruz Academic Advisor III / Interim Assistant Director of Summer Bridge #2 John Brewers Bay St. Thomas U.S. Virgin Islands 00802-9990 jcruz2@uvi.edu