High School Teacher, Administrator, or Counselor Recommendation

This form is part of the application packet for the DO-IT Scholars program. Application packets must be complete before they can be reviewed. To learn about the other components of the application package, see Applying.��

Instructions: A teacher, counselor, or administrator must complete the form below and the eight essay questions. If you prefer, you can print this form and submit it to DO-IT by postal mail, fax, or email.��You can also access the full application in Spanish, Russian, or Vietnamese.

Deadline: January 30th. Applications for the upcoming summer are accepted throughout the school year; however, priority is given to applications received by��January 30th. Applications received after January 30th will be considered on a space available basis.

All DO-IT Scholars program offerings are contingent upon receipt of continued funding. All DO-IT Scholar participants are required to be residents of Washington State. The �r�� reaffirms its policy of equal opportunity regardless of race, color, creed, religion, national origin, sex, sexual orientation, age, marital status, disability, or status as a disabled veteran, or Vietnam era veteran in accordance with University policy and applicable federal and state statutes and regulations.

View UW and DO-IT’s Privacy Practices for Youth Programs here: English�� | | | | |

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About You

First Name *

Last Name *

Position/Title

Address1 *

Address2

City *

State *

Zipcode *

Phone *

Please use the format XXX-XXX-XXXX

Email *

Student applicant's First Name *

Student applicant's Last Name *

High School Name *

District number *

School Address1 *

School Address2

School City *

School State *

School Zipcode *

About Applicant

Grade level, current academic year *

How much time do you spend with the student per week? *

Applicant’s disability *

Percentage of the applicant’s time spent in Specially Designed Instruction (SDI)? *

Indicate academic area of SDI *

Respond to each of the questions below. ��You may enter text in the field provided or upload a single alternative file,��if needed. Your honest and thorough assessment of this applicant is helpful.

1. What is the nature of the student’s disability and how does it affect them academically? *

2. What types of accommodations and supports does this student use at school presently? *

3. What academic and social support are they receiving to promote their success as they transition toward college? *

4. How have they grown in their academic achievement since coming to high school? *

5. Please comment on this student’s academic interests. *

6. Please comment on this student’s potential to complete a college program. *

7. Please comment on how this student works in group learning environments. *

8. Please comment on this student’s computer skills. *

9. Please comment on why you think this student is a good candidate for the DO-IT Scholars program. How would they benefit from this program as described in the DO-IT Scholar brochure? *

10. Additional comments (optional).

File Upload (alternative format for Questions 1-10)

10 MB size limit
Files must be less than 10 MB.
Allowed file types: txt rtf html pdf doc docx ppt pptx xls xlsx xml avi mov mp3 ogg wav.

Leave this field blank

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