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Breakthrough San Francisco Student Application

Application Deadline: Friday, February 10, 2023

感謝您對Breakthrough的關注!學生和家庭應仔細閱讀以下所有信息。


Breakthrough接受不同種族,信仰或膚色的學生,並致力於選擇代表舊金山多樣性的學生。請注意,申請人必須至少滿足我們五個要求中的三個:潛在的家中第一代大學生;有資格享受免費或減價午餐;在家裡說英語以外的語言;生活在單親家庭中;和/或在資源不足的學校讀書。




2023年夏季的選擇時間表


在線申請和家長/監護人報名截止日期:2023年 2月10日


Breakthrough工作人員審閱申請的時間:2023年 2月20日至 26日


錄取通知函的寄出:23年3月31日



“Breakthrough舊金山是一個全年開放的學習補充課程,適用於受教育機會有限的積極進取的舊金山學生。學生申請成為四年級生並做出為期八年的承諾,目標是就讀最適合的四年制大學。所有課程都是免學費的,並在San Francisco Day School350 Masonic Ave, San Francisco, CA 94118)授課。要了解更多信息,請訪問我們的網站www.breakthroughsf.org
BTSF
Student Section: We are interested in getting to know each student who applies to Breakthrough so this section should ONLY BE COMPLETED BY THE STUDENT.  If you have any questions as you complete this portion of the application, please reach out to an adult.
Student Contact Information
Student Language(s)
Student Section: We are interested in getting to know each student who applies to Breakthrough so this section should ONLY BE COMPLETED BY THE STUDENT.  If you have any questions as you complete this portion of the application, please reach out to an adult.
Teacher Recommendation
Breakthrough requires one recommendation as part of the application process.  Please list the teacher who will provide your recommendation.  Your parent / guardian will be asked to provide their email address in the parent section of the application.
Please provide the teacher's full name.
Breakthrough History

If more than one, choose the option that was most influential in applying for Breakthrough
Names of family members, teachers, etc.
School Information
ID number issued to you by the school or district.
Affiliate Instruction
For all short answer and essay questions you need to populate the question(s) below AND in the Connector in order for the record in Salesforce to show the question they are answering. These instructions are for your use and will be hidden from applicants.
Short Answer Questions:  Please answer all of the questions in AT LEAST 2 sentences.  We want to see your best work!  You may copy/paste from a Word document if you like.
1. Describe​ ​a​ ​time​ ​when​ ​you​ ​did​ ​something​ ​difficult​ ​or​ ​outside​ ​your​ ​“comfort​ ​zone.”​ ​What​ ​was​ ​the​ ​outcome? What​ ​did​ ​you​ ​learn​ ​from​ ​the​ ​experience?

Your answer is required in order to submit.
2. What are your favorite things to do outside of school (hobbies, special interests, etc.)? Why do you enjoy them?

Your answer is required in order to submit.
3. Breakthrough is a long-term commitment. See program description for a full explanation of the commitment. Why do you want to be a part of Breakthrough, and why do you feel ready for this commitment? What do you hope to gain?

Your answer is required in order to submit.
Essay:  Please answer the questions below using AT LEAST 8-10 sentences.  We want to see your best work!  You may copy/paste from a Word document if you like.
1. Consider a community of which you are part (e.g., neighborhood, school, or church) and reflect on one challenge faced by that community. How can you help solve this challenge?

Your answer is required in order to submit.
2. If you could fast-forward into the future and see yourself, where do you think you will be in the next 10-15 years? What kinds of things will you be doing?  What type of job will you have? How will you achieve these goals? Where will you be living? Describe in detail what your life will be like in the future.

Your answer is required in order to submit.

家庭部分:本申請的這一部分僅應由父母/監護人填寫。 Breakthrough將仔細,保密並整體地審閱所有信息。

家長/監護人信息 (Parent / Guardian Information)
First Name
Last Name
Gender
Gender Specify
Birth Country
Home Address Street
Home Address City
Home Address State
Home Address Zip Code
My address is the same as my student.
Email
Home Phone
Cell phone
Work Phone
Preferred contact method
Please select the best day(s) to contact you.
Please select the best time(s) to contact you.

工作经历 (Employment History)

Employment Status
Employer Name

教育背景 (Education History)

Does your student qualify as a first-generation college student (i.e. Neither parent has a 4-year degree from the US)?
Highest level of education completed
Country of Bachelor's degree

家中語言 (Home Language)

What language do you speak primarily at home?
Is there a secondary language you speak at home?
What secondary language do you speak at home?
Are there any other languages you speak at home?
What additional language(s) do you speak at home? Select all that apply.
How comfortable are you with English?
Would you need documents and communication to be translated for you?

關係細節 (Relationship Details)

Is the student being raised in a Single Parent household?
What is your relationship to the student?
Do you have a spouse or partner who lives in the same household as you and your student?
What is your spouse/partner's relationship to the student?
Is there any other adult(s) involved in the student's upbringing or living in your home that we should be in contact with?
Please provide details on other adult(s): Ex: Name, relationship, contact information, etc.
How much of the time does your student live with you?
Does the student receive additional financial support from another parent or guardian?
Where does the student live when not living with you?
Please explain any additional things to know about the student's family or family structure below:
I would like to enter information for a second Parent/Guardian:
家長/監護人#2 信息 (Parent / Guardian #2 Contact Information)
Does Parent/Guardian #2 live in the same household as Parent/Guardian #1?
I am only comfortable providing basic contact information on behalf of 'Parent / Guardian #2'.
First Name:
Last Name:
Gender
Gender Specify:
Birth Country:
Home Address Street:
Home Address City:
Home Address State:
Home Address Zip Code:
Home Phone:

關係明細 (Relationship Details)

What is their relationship to the student?
How much of the time does the student live with them?
Cell Phone:
Work Phone:
Email Address:
Preferred means of contact:
Please select the best day(s) to contact them:
Please select the best time(s) to contact them:

工作经历 (Employment History)

Employment status:
Employer name:

学习经历 (Education History)

Their highest level of education completed:
Country of Bachelor's degree

家中語言 (Home Language)

What language is primarily spoken in their home?
Is there a secondary language spoken at their home?
What secondary language do they speak at their home?
Are there any other language(s) they speak at home?
What additional language(s) do they speak at home? Select all that apply.
What additional language(s) do they speak at home? Select all that apply.
Would they need documents and communication to be translated?

家庭部分:本申請的這一部分僅應由父母/監護人填寫。 Breakthrough將仔細,保密並整體地審閱所有信息。

Breakthrough歷史 (Breakthrough History) 

How did you hear about Breakthrough?
Other - please explain:
Please provide details on how you heard about Breakthrough. Names of family members, teachers, etc.
Do you have any other children or relatives in the program?
What is their relationship to the student applicant?
Please provide details of the Breakthrough student(s): name(s), relationship type(s), Breakthrough site(s), and their current grade level(s):
家庭背景 (Family Background)
Is your monthly income fixed or flexible?
What is your estimated ANNUAL pre-tax household income for 2022?
How many people living in your household are under the age of 18?
How many people in your household are 18 years of age or older?
Please feel free to share any other information that would help us understand your family's financial situation, including effects of COVID.

家庭部分:本申請的這一部分僅應由父母/監護人填寫。 Breakthrough將仔細,保密並整體地審閱所有信息。


學生背景 (Student Background)
Does your student qualify for free or reduced lunch? If you are unsure if your student qualifies, visit this website to calculate free or reduced price lunch status: https://www.benefits.gov/benefit/1953 (copy and paste into a new browser).
Is your student Hispanic or Latinx?

Which of the following choices describe your student's race? Select all that apply.
Please specify student's country/ies of origin. Hold down the Ctrl button to choose more than one.
Please list or describe any other communities your student identifies with. Can be specific ethnicity (Hmong, Chinese, Nigerian), religious affiliation (Muslim, Jewish, Jain), or any other community your student identifies with.
How will your student get to/from Breakthrough?

Other transport:
Does your student currently participate in any other programs or activities? Examples: Sports, Avid, Boys and Girls Club, Religious Activities, etc.

Please describe your student's other commitment(s). How many hours per week does your student dedicate to each activity and how flexible are these commitments?
Do you foresee any conflicts with the dates of the program?

Please explain conflicts/concerns:
To ensure that your child receives the consideration, support and encouragement they need while in Breakthrough, please share any educational support/services your student has or is currently receiving. Please select all that apply. If applicable (i.e. speech therapy, extra tutoring, medication, any accomodations, IEP, 504 Accomodation plans, RSP, etc.)
Please describe educational support/ services:
Please upload your student's final 3rd grade report card below or email to apply @breakthroughsf.org.
Please upload your student's most recent 4th grade report card below or email to apply@breakthroughsf.org.
Breakthrough is a rigorous 8-year academic commitment. How will you help your student fulfill this commitment? Please explain:
Please upload a student photo (waist up, plain background and smile).

家庭部分:本申請的這一部分僅應由父母/監護人填寫。 Breakthrough將仔細,保密並整體地審閱所有信息。

Affiliate Instruction
For all short answer and/or essay questions you need to populate the question(s) below AND in the Connector in order for the record in Salesforce to show the question they are answering. These instructions are for your use and will be hidden from applicants.
簡短回答問題:回答以下問題,以幫助我們了解您的學生。 如果願意,可以從Word文檔中復制/粘貼. (Short Answers Questions)
1. 你喜欢你的学生什么?你希望我们了解他们什么?

What do you love about your student? What would you like us to know about them?
2. 你对你的学生有什么目标?您如何看待 Breakthrough 适合您学生的未来?

What goals do you have for your student? How do you see Breakthrough fitting into your student's future?
學生的學校信息 (Student School Information)
Name of student's current school:
Other School:
Will the student be attending the same school next year?
Student's new school name:
Please list the school counselor or registrar at your student's school:
推荐信息:突破需要推荐作为其申请过程的一部分。您的学生已经提供了老师的姓名,请提供老师的邮箱地址,我们会直接通过邮件联系这些老师。(Recommendation Information)  

推荐人 Recommender
如果此姓名不正确或拼写错误,请在本表格第 3 页的学生部分下更正。If this name is incorrect or mispelled, please correct under the student section on page 3 of this form.
突破预期 Breakthrough Expectations


突破性旧金山学生做出八年的承诺。在五年级至八年级之前的暑假期间,学生参加我们为期六周的暑期学术课程,每晚完成大约一小时的家庭作业。在五年级至八年级学年期间,学生每周两个下午参加 Breakthrough 以获得学术支持。在九至十二年级期间,学生每月参加周六的研讨会。学生和家庭也应参与中学、高中和大学的招生支持,并认真考虑 Breakthrough 工作人员的意见和建议。必须出席;我们希望我们的学生和家庭在他们与我们一起度过的八年时间里,围绕 Breakthrough 计划计划所有其他承诺。



通过选中下面的框,您承认您了解 Breakthrough 对其计划接受的学生和家庭的期望。

Please confirm your commitment by checking the box below
在您看到确认屏幕之前,处理申请最多可能需要 1 分钟。请不要再次点击提交。感谢您的耐心等待!
This must have a "Default Value" populated with the Application Record Type ID for each affiliate as part of launch. This is found in Setup>Object Manager>Application>Record Types>Application>then get the ID from URL. Connector won't work until this is done.