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Breakthrough Louisville Student Application

Application Deadline: May 1, 2025
Fecha límite de solicitud: 1 de mayo
 
Thank you for your interest in Breakthrough!  Students and parents should carefully read all of the information below. 

Breakthrough Louisville is a free, 6-week summer academic program for under-resourced middle school students (rising 6th - 9th graders) in Jefferson County, KY.   We have a dual mission of building academic confidence and introducing college students to the teaching profession.  
Breakthrough Louisville es un programa académico de verano gratuito de 6 semanas para estudiantes de secundaria de bajos recursos (estudiantes que ingresan al sexto grado y al noveno grado) en el condado de Jefferson, KY.  Tenemos la doble misión de generar confianza académica e introducir a los estudiantes universitarios en la profesión docente.


Breakthrough Louisville is committed to selecting a class of students who approximate the ethnic, racial, religious and cultural diversity of our city.  Breakthrough accepts students regardless of race, creed or color; we are committed to selecting a diverse group of students who benefit from the program.  PROGRAM RUNS FROM JUNE 9th to JULY 18th, 2025.  ONLY 3 ABSENCES ARE ALLOWED DURING THE 6 WEEK PROGRAM.  Please do not apply if your child cannot attend all 6 weeks.

Breakthrough Louisville se compromete a seleccionar una clase de estudiantes que se aproximen a la diversidad étnica, racial, religiosa y cultural de nuestra ciudad.  Breakthrough acepta estudiantes sin importar raza, credo o color; Estamos comprometidos a seleccionar un grupo diverso de estudiantes que se beneficien del programa.  EL PROGRAMA FUNCIONA DEL 9 DE JUNIO AL 18 DE JULIO DE 2025. SOLO SE PERMITEN 3 AUSENCIAS DURANTE EL PROGRAMA DE 6 SEMANAS.  No presente la solicitud si su hijo no puede asistir las 6 semanas.


Selection Timeline for Summer: Completed applications need to be submitted (at the latest) by May 1.  Applications received by that date will be given preference.  After May 1, if openings exist, candidates will be considered.  

Selection Timeline for Summer:  Las solicitudes completas deben enviarse (a más tardar) antes del 1 de mayo. Se dará preferencia a las solicitudes recibidas antes de esa fecha.  Después del 1 de mayo, se considerarán los candidatos si aún existen vacantes.


Online Application and Parent / Guardian Packet Due Date:  May 1 

Fecha de vencimiento de la solicitud en línea y del paquete para padres/tutores: 1 de mayo



Applications Reviewed by Breakthrough Staff:  Applications will be reviewed as they are received and families notified as soon as all materials are verified and student is deemed a good fit for our program. We cannot accept all students.

Solicitudes revisadas por el personal de Breakthrough: Las solicitudes se revisarán a medida que se reciban y se notificará a las familias tan pronto como se verifiquen todos los materiales y se considere que el estudiante es apto para nuestro programa. No podemos aceptar a todos los estudiantes.


Interviews:  TBD 

Entrevistas: se determinará en una fecha posterior


Decision Letters Mailed:  Families will be notified by email as soon as application is completed and verified. 

Cartas de decisión enviadas por correo: Las familias serán notificadas por correo electrónico tan pronto como se complete y verifique la solicitud.




Breakthrough Site Information:  Our program is held on the Louisville Collegiate Campus (2427 Glenmary Ave., 40204).  The school donates its space to Breakthrough Louisville during the summer.

Información innovadora sobre el sitio: Nuestro programa se lleva a cabo en Louisville Collegiate Campus (2427 Glenmary Ave., 40204).  La escuela dona su espacio a Breakthrough Louisville durante los meses de verano.

Scholar

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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 or Other Recommenders
Breakthrough requires two recommendations as part of the application process.  Please list the teachers who will provide your recommendations.  Your parent / guardian will be asked to provide their email addresses in the parent section of the application.
Please provide the teacher's full name.
Please provide the teacher's full name.
Breakthrough History

Si hay más de una, elija la opción que fue más influyente al solicitar  Breakthrough 
Names of family members, teachers, etc.
School Information

Número de identificación emitido a usted por la escuela o el distrito.
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.
1.  Why do you want to attend Breakthrough Louisville this summer?

Se requiere su respuesta para poder enviar.
2. Name 3 things you like about school and why.

Se requiere su respuesta para poder enviar.
3.  Identify 2 challenges you face in school with detail. 

Se requiere su respuesta para poder enviar.
Essay:  Please answer the questions below using 250 words or less.  We want to see your best work!  You may copy/paste from a Word document if you like.
1. What is something you want to learn about this summer?  Also, describe something unique about yourself. 

Se requiere su respuesta para poder enviar.
2. What careers are you interested in when you grow up? Why do they interest you?  What steps can you take to get there? How important is doing well in school necessary to achieve these goals? 

Se requiere su respuesta para poder enviar.

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

Breakthrough Louisville solo tiene éxito si su estudiante puede asistir durante las 6 semanas completas.  Solicite solo si sabe que su hijo estará en el campus todos los días de la semana durante nuestra sesión de 6 semanas.
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?
Is 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):
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?
Has anything happened in the last year that has impacted the accuracy of the information provided on your current financial situation?

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? If you are unsure if your student qualifies, visit this website to calculate free or reduced price lunch status: https://reports.educateiowa.gov/ICAVES/Home/Calculator (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:
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 6-week 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.
1.  ¿Por qué quiere que sus estudiantes participen en Breakthrough Louisville este verano?

Why do you want your student to participate in Breakthrough Louisville this year? Your answer is required in order to submit.
2.  Proporcione cualquier información que crea que sería útil para nuestro personal para ayudar a su hijo a tener éxito.

Please provide any information you feel would be helpful to our staff in helping your child succeed. Your answer is required in order to submit.
3.  Si su hijo tiene un interés específico en algo que podríamos fomentar, tenga en cuenta a continuación.

If your child has a specific interest in something we could encourage, please note below. Your answer is required in order to submit.
Información de la escuela del estudiante (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:
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:
Breakthrough Expectations
Breakthrough Louisville es un programa de 6 semanas que solo es beneficioso cuando el estudiante puede estar allí durante todo el programa. Si su hijo tiene conflictos que no le permitirán participar durante las 6 semanas completas, no presente la solicitud.  ¡Solo podemos aceptar 60 estudiantes y queremos que cada estudiante tenga la oportunidad de triunfar!

Al marcar la casilla a continuación, usted reconoce que comprende las expectativas que Breakthrough tiene para sus estudiantes y familias aceptadas en su programa.

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.

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