RISE Summer Math Boost Camp

RISE Summer Math Boost Camp
RISE – Helping students Rise to their potential
A Partnership between Salt Lake Community College, the Granite School District and the Utah
System of Higher Education.
WHO: You are invited to a Summer Math Boost Camp for current 11th graders at Cyprus, Hunter, Granger,
and Kearns High Schools. To qualify for the Summer Math Boost Camp, you must have math ACT scores
between 17 and 21.
WHAT: This four-week program will help you improve your math scores in order to place into a concurrent
enrollment math course your senior year.
WHERE: The Summer Math Boost Camp will take place at Salt Lake Community College, West Valley Center,
conveniently located at 3500 South and 5600 West in West Valley City.
HOW: To apply for the RISE Summer Math Boost Camp, simply fill out this form. Admittance will be
determined by math ACT scores, past math course grades, and recommendations from school faculty and staff.
Seats are limited so act now!
This is your invitation to begin your path to college, today!
STUDENT INFORMATION
Student Name:_________________________________________________________ Student #:_________________________
Address:______________________________________________________________________________________________________
Street
City
State
Zip
Student Preferred Email Address: _________________________________________________________________________
Home Phone #:___________________________________ Cell #:___________________________________________________
Text? ☐Y ☐N
Date of Birth:_________________________________
Expected Graduation Date: _______________
High School: ☐ Cyprus ☐ Granger ☐ Hunter ☐ Kearns
Which of the following best represents your racial/ethnic heritage:
☐ African American/Black
☐ Asian
☐ Caucasian
☐ Native American/Alaska Native
☐ Pacific Islander/Native Hawaiian
☐ More than one
Do you qualify for free/reduced lunch? ☐Y ☐N
Did either of your parents graduate from college? ☐Y ☐N
PARENT/GUARDIAN INFO (Información del padre o guardián)
Parent/Guardian Name(s):_________________________________________________________
Address:______________________________________________________________________________________________________
Street
City
State
Zip
Preferred Email Address: _________________________________________________________________________
Home Phone #:___________________________________ Cell #:___________________________________________________
Text? ☐Y ☐N
Indicate sessions for which your student is available. Your student will attend only one session.
Indique a que secciones el estudiante está disponible. El estudiante atenderá solo a una sección.
Availability:
☐Y (Si) ☐N (No)
☐Y (Si) ☐N (No)
☐Y (Si) ☐N (No)
☐Y (Si) ☐N (No)
Session 1: June 6th-30th, Monday through Thursday, 9am-noon.
Session 2: June 6th-30th, Monday through Thursday, 12:30-3:30pm.
Session 3: July 5th-29th, Tuesday through Friday, 9am-noon.
Session 4: July 5th-29th, Tuesday through Friday, 12:30-3:30pm.
We will notify you about which session your student will attend.
Notificaremos a que sección el estudiante atenderá.
I give permission to release my student’s academic information to SLCC and the RISE Program.
Yo doy divulgación de información académica de mi estudiante a SLCC y a el Programa RISE.
☐Y (Si)
I grant my child permission to participate in this program.
Concedo permiso a mi hijo para participar en este programa.
Parent/Guardian Signature (Firma):_________________________________________________
Date (Fecha): ________________________
Please return your completed application to:
Your RISE Advisor, Your High School Counselor, or:
Salt Lake Community College
Attn. Kevin Miller
PO Box 30808
Salt Lake City, UT 84130
Kevin.miller@slcc.edu
This project was paid for by a StepUP READY Grant, provided by the Utah System of Higher Education. The goal of StepUP READY is to
create opportunities for public education and higher education to work together to effect meaningful change in the college readiness of Utah’s
students.
AA/EO INSTITUTION | REV. 04-05-16
Individuals requiring ADA accommodations may contact Outreach & Access Department at 801-957-2122.