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Breakthrough Houston Student Application 2024 (Spanish)

Priority Application Deadline: March 20th, 2024 
APPLICATIONS WILL CONTINUE TO BE ACCEPTED ON A ROLLING BASIS.

APPLY NOW! WE WOULD LOVE TO HEAR FROM YOU!
EMAIL APPLY@BREAKTHROUGHHOUSTON.ORG WITH ANY QUESTIONS.

Thank you for your interest in Breakthrough Houston!  Students and parents should carefully read all of the information below. 


Breakthrough Houston is committed to selecting a class of students who approximate the ethnic, racial, religious and cultural diversity of our city.  Breakthrough Houston accepts students regardless of race, creed or color; we are committed to selecting a diverse group of students who benefit from the program.

Breakthrough Houston se compromete a seleccionar una clase de estudiantes que se aproximen a la diversidad étnica, racial, religiosa y cultural de nuestra ciudad. Breakthrough Houston acepta estudiantes independientemente de su raza, credo o color; estamos comprometidos a seleccionar un grupo diverso de estudiantes que se beneficien del programa.


Cronograma de selección para el verano de 2024:



Solicitudes revisadas por el personal de Breakthrough: marzo - mayo 2024


Entrevistas: enero - mayo 2024


Cartas de decisión enviadas por correo: mayo 2024


BTH2021
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.

Sección Estudiante: Nos interesa conocer a cada estudiante que aplica a Breakthrough por lo que esta sección SÓLO DEBE SER COMPLETADA POR EL ESTUDIANTE. Si tiene alguna pregunta mientras completa esta parte de la solicitud, comuníquese con un adulto.
Student Contact Information
Primer Nombre
Segundo Nombre
Apellido
Nombre preferido/apodo
dirección de correo electrónico
teléfono de casa
teléfono móvil
género
fecha de nacimiento
país de nacimiento
dirección de casa
Ciudad
Estado
código postal
School Information (Información de la escuela del estudiante)
Nombre de la escuela actual del estudiante:
Otro Escuela:
¿Asistirá el estudiante a la misma escuela el próximo año?
Nombre de la escuela nueva:
Grado para 2022-2023:
Número de identificación de la escuela de su estudiante. ID number issued to you by the school or district.
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.

Sección Estudiante: Nos interesa conocer a cada estudiante que aplica a Breakthrough por lo que esta sección SÓLO DEBE SER COMPLETADA POR EL ESTUDIANTE. Si tiene alguna pregunta mientras completa esta parte de la solicitud, comuníquese con un adulto.
Teacher or Other Recommenders
Breakthrough requires 2 teacher recommendations as part of the application process.  Please list the teachers who will provide your recommendations and provide their email addresses. 

Breakthrough requiere la recomendación de 2 maestros como parte del proceso de solicitud. Enumere los maestros que le brindarán sus recomendaciones y proporcione sus direcciones de correo electrónico.
Nombre del primero recomendador
Correo electrónico del primero recomendador
Nombre del segundo recomendador
Correo electrónico del segundo recomendador
Breakthrough History

If more than one, choose the option that was most influential in applying for Breakthrough
Names of family members, teachers, etc.
Affiliate-Specific Instructions
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.
Short Answer Questions:  Please answer all of the questions below using at least 2 sentences.  We want to see your best work!  You may copy/paste from a Word document if you like.

Your answer is required in order to submit.
2. In a short paragraph of 3-5 sentences, tell us why you want to join the Breakthrough community. 
Then, in 3-5 sentences, describe how you think Breakthrough will help you reach your future goals and dreams. 

Your answer is required in order to submit.

Family Section: This section of the application should ONLY BE COMPLETED BY A PARENT / GUARDIAN.

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 the student's:
Email Address:
Home Phone:
Cell Phone:
Work Phone:
Preferred means of contact:
Please select the best day(s) to contact you:
Please select the best time(s) to contact you:

Historial de empleo (Employment History)

Employment status:
Employer name:

Historia de la Educacion (Education History)

Does your student qualify as a first-generation college student (i.e. neither parent has a 4-year degree from the US)? A first-generation student means BOTH parents did not complete a 4-year college or university degree (or higher). If a degree was obtained from a country other than the United States, a student qualifies as a first-generation student.
Highest level of education completed:
Country of Bachelor's degree

Idiona(s) del Hogar (Home Language(s))

What language do you primarily speak at home?
Is there a secondary language you speak at home?
What secondary language do you speak at home?
Are there any other language(s) 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?

Detalles de la Relacion (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?
Are there any other adult(s) involved in the student's upbringing or living in your home that we should be in contact with? 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:
Información de Contacto del Otro Padre/ Tutor (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:

Detalles de la Relacion (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:

Historial de Empleo (Employment History)

Employment status:
Employer name:

Historia de la Educacion (Education History)

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

Idiona(s) del Hogar (Home Language(s))

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.
How comfortable are they with English?
Would they need documents and communication to be translated?

Family Section: This section of the application should ONLY BE COMPLETED BY A PARENT / GUARDIAN.  Breakthrough will review all information carefully, confidentially, and holistically.

Historal de Breakthrough (Breakthrough History)

How did you hear about Breakthrough? Select all that apply.
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):

Family Section: This section of the application should ONLY BE COMPLETED BY A PARENT / GUARDIAN.  Breakthrough will review all information carefully, confidentially, and holistically.

Antecedentes del Estudiante (Student Background)
 
Does your student qualify for Free or Reduced Price Lunch? 
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:
Breakthrough provides students with access to public transportation, but students often travel to and from the program alone. Would you allow your child to travel alone on public transportation: Check all that apply.
Ejemplos: Deportes, Avid, Boys and Girls Club, actividades religiosas, etc. 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:
Breakthrough is a rigorous 10-year academic commitment. How will you help your student fulfill this commitment? Please explain:
Please upload a student photo (optional):

Family Section: This section of the application should ONLY BE COMPLETED BY A PARENT / GUARDIAN.  Breakthrough will review all information carefully, confidentially, and holistically.

Affiliate-Specific Instructions
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.
Preguntas de Respuesta Corta : Ayuudenos a concocer a su estudiante respondiendo a las preguntas a continuacion.  Por favor escriba al menos dos oraciones completas. (Short Answer Questions: Help us get to know your student by responding to the questions below.  You may copy/paste from a Word document if you like.)
1.  ¿Por qué le gustaría que su estudiante fuera parte de Breakthrough?

Why would you like your student to be a part of Breakthrough? Your answer is required in order to submit.
2.  ¿Qué amas de tu estudiante? ¿Qué le gustaría que supiéramos sobre ellos?

What do you love about your student? What would you like us to know about them? Your answer is required in order to submit.
Please list the school counselor or registrar at your student's school:
Recommendation Information: Breakthrough requires two recommendations as part of the application process. Your student has already provided names, please provide the email address and we will contact these teachers directly via email. 
Recomendante 1
If this name is incorrect or mispelled, please correct under the student section on page 3 of this form.
1a. Recommender's Email:
Recomendante 2
If this name is incorrect or mispelled, please correct under the student section on page 3 of this form.
2a. Recommender's Email:
Additional Paperwork
To complete your application, please submit a copy of the student's most recent report card or bring a physical copy to your interview. 

Para completar su solicitud, envíe una copia de la boleta de calificaciones más reciente del estudiante o traer una copia a su entrevista. 
Report Card
STAAR Exam Scores
Si no se carga la boleta de calificaciones más reciente, el director del programa de su estudiante solicitará una copia.
Antecedentes de Familia (Family Background)
Is your monthly income fixed or flexible?
What is your ANNUAL pre-tax household income last year:
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 upload your 1040 (optional): Form 1040 is an IRS tax form used for personal federal income tax returns filed by United States residents. The form calculates the total taxable income of the taxpayer. IRS 1040 form can be found here : https://www.irs.gov/pub/irs-pdf/f1040.pdf (copy and paste into a new browser).
Has anything happened in the last year that has impacted the accuracy of the information provided on your current financial situation?
Breakthrough Expectations
Al marcar la casilla a continuación, reconoce que comprende las expectativas que Breakthrough tiene para sus estudiantes y familias aceptados en su programa.

Las expectativas para las familias son las siguientes:
1. Revise el correo electrónico con frecuencia para ver las actualizaciones de las solicitudes de los estudiantes
2. Comuníquese con el director del programa si tiene preguntas sobre la participación de los estudiantes
3. Reconocer que Breakthrough es un sistema de apoyo y compromiso lleno de diversión de 10 años para su estudiante y su familia.

Please confirm your commitment by checking the box below. Your answer is required in order to submit.
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 the get the ID from URL. Connector won't work until this is done.
Por favor note: podrá tomar hasta un minuto para procesar la aplicación antes de que vea la confirmación. Por favor no ingrese la aplicación dos veces. Muchas gracias por su paciencia.

It may take up to 1 minute for the application to process before you see the confirmation screen. Please do not hit submit a second time. Thank you for your patience!
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