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Referral Form for Gateway to College

If you encounter a student you think could benefit from attending Gateway to College, please complete this form. We'll then follow up with the student to give them additional information about the program and the application process.


Your Name*
(in case we have questions about your referral)
Student Name*
Do you know the student or parent's email or phone?*
This student is:*
If "other" please explain
Are you a school counselor or administrator who is helping a student complete their application to Gateway to College?
How many periods, days, or their attendance percentage.
Upload student's unofficial transcript*
No File Chosen
File uploads may not work on some mobile devices.
Does the student have a learning plan?*
Upload a copy of the learning plan.*
No File Chosen
File uploads may not work on some mobile devices.
Cancel
Confirm