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New Student Application 2025

Application Deadline: Monday, February 17, 2025

Thank you for your interest in Breakthrough! Students and parents should carefully read all of the information below. Please note that there is also a bilingual application with student sections in English and parent sections in Spanish.

Breakthrough San Juan Capistrano is a community-based program that empowers motivated students with backgrounds underrepresented in higher education to achieve academic success from middle school through college graduation.

STUDENTS MUST MEET TWO OF THE FOLLOWING:

Low-income household/Household makes under $ 80,000 yearly
First-generation: Parent(s) did not graduate college or university in the U.S.
Historically underrepresented in higher education

STUDENTS MUST MEET ALL OF THE FOLLOWING:

Academically Motivated with a minimum GPA of 3.5
Currently attending Marco Forster Middle School
Committed to attending school year and summer programming
Attended one New Student Recruitment Info Meeting
Tuesday, January 15, 2025, 6:00-7:30 p.m.

Location: Multi-Purpose Room at Marco Forster Middle School

Tuesday, January 16, 2025, 6:00-7:30 p.m.

Location: Casa Unidos, 31341 Los Rios St, San Juan Capistrano

Thursday, January 25, 2024, 5:30-7:00 p.m.

Location: Boys & Girls Club, 1 Via Positiva, San Juan Capistrano

SELECTION TIMELINE FOR NEW STUDENTS 2023-2024:

New Student Online Application Due Date: February 17, 2025
Super Saturday (*in-person, students only): Saturday, March 15, 2025, 9:00 am -12:00 pm
Family Interviews (*in-person, scheduled 25 mins): March-April 2025
Admission Decisions Announced: April 19, 2025
New Student Orientation & Pre-Summer Assessment: May 3, 2025, 9:00 am-2:00 pm

Application Tip: Save Your Login Information

To make your application process smoother, it's crucial to save your login details. Write down your username and password on a sticky note and keep it in a secure but accessible place. This will help you easily log back into your application if needed. Additionally, ensure that you use a non-CUSD email when applying. This helps avoid any issues with email filtering and ensures you receive all important communications related to your application.

For questions, please contact Assistant Director of Middle, Tania Solano Cervantes, via email tania.solanocervantes@smes.org or call 949.661.0108 ext. 1316.

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

First Name:

Middle Name:

Last Name:

Preferred Name/ Nickname:

Email Address:

Home Phone:

Student Cell Phone:

Gender:

Gender Specify:

Birth Date:

Birth Country:

Home Address Street:

Home Address City:

Home Address State:

Home Address Zip Code:

Student Language(s)

What language do you speak most of the time, at home?

Do you speak any other language(s) at home?

What is the second most common language you speak at home?

Are there any other language(s) you speak at home?

Select any other language(s) you speak at home:

Arabic	Bengali	Cantonese/Yue	Creole
English	French	German	Hindi
Hmong	Italian	Japanese	Javanese
Korean	Malay	Mandarin/Chinese	Marathi
Portuguese	Punjabi	Russian	Spanish
Tamil	Telugu	Turkish	Urdu
Vietnamese	Wu	Language Not Listed

Teacher or Other Recommenders

Breakthrough requires two recommendations as part of the application process. Please list the teachers who will provide your recommendations. The first recommender must be from your English or Social Sciene teacher. The second recommender must be from your Math or Science teacher. Your parent/guardian will be asked to provide their email addresses in the parent section of the application.

Recommender 1:

Please provide the teacher's full name.

Recommender 2:

Please provide the teacher's full name.

Breakthrough History

How did you hear about Breakthrough?

Breakthrough presentationBreakthrough staff memberFamily connectionTeacherBreakthrough studentOtherIf more than one, choose the option that was most influential in applying for Breakthrough

Other - please explain:

Please provide details on how you heard about Breakthrough:

Names of family members, teachers, etc.

School Information

Current Grade:

Short Answer Questions: Please answer all of the questions below using at least 2 sentences and no more than 5 sentances. We want to see your best work! You may work on your responses on a Word or Google document and then copy/paste here when you are ready. Please don't forget to click "Save"!

1. Breakthrough is a 10-year long-term 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?

Student Short Response Answer #1

Your answer is required in order to submit.

2. Breakthrough is an opportunity to grow academically, socially, and personally. What areas of growth would you focus on personally at Breakthrough and why?

Student Short Response Answer #2

Your answer is required in order to submit.

3. What are your favorite things to do outside of school (hobbies, special interests, etc.)? Why do you enjoy them?

Student Short Response Answer #3

Your answer is required in order to submit.

4. What does being a leader mean to you? Describe a time when you were a leader.

Student Short Response Answer #4

Your answer is required in order to submit.

Essay: Please answer the questions below using 250 words or less. We want to see your best work! You may work on your responses on a Word or Google document and then copy/paste here when you are ready. Please don’t forget to click “Save”!

1. At Breakthrough, we understand students are faced with important decisions every day. Please write about one difficult decision you have had to make. Why did you make that decision? What were the consequences of your decision? How did this decision affect your life? Would you make this decision again?

Student Essay Answer #1

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.

Student Essay Answer #2

Your answer is required in order to submit.

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

[INPUT AFFILIATE SPECIFIC TEXT FOR PARENTS]

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:

Email Address:

Home Phone:

Cell Phone:

Work Phone:

Preferred means of contact:

Please select the best day(s) to contact you:

MondayTuesdayWednesdayThursdayFriday

Please select the best time(s) to contact you:

MorningAfternoonEvening

Employment History

Employment status:

Employer name:

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

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.

Arabic	Bengali	Cantonese/Yue	Creole
English	French	German	Hindi
Hmong	Italian	Japanese	Javanese
Korean	Malay	Mandarin/Chinese	Marathi
Portuguese	Punjabi	Russian	Spanish
Tamil	Telugu	Turkish	Urdu
Vietnamese	Wu	Language Not Listed

How comfortable are you with English?

Would you need documents and communication to be translated for you?

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:

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:

Email Address:

Home Phone:

What is your relationship to the student?

Cell Phone:

Work Phone:

Preferred means of contact:

Please select the best day(s) to contact them:

MondayTuesdayWednesdayThursdayFriday

Please select the best time(s) to contact them:

MorningAfternoonEvening

Employment History

Employment status:

Employer name:

Education History

Their highest level of education completed:

Country of Bachelor's degree

Home Language

What language do you primarily speak at home?

Is there a secondary language you speak at home?

What secondary language do you speak at their home?

Are there any other language(s) you speak at home?

What additional language(s) do they speak at home? Select all that apply.

Arabic	Bengali	Cantonese/Yue	Creole
English	French	German	Hindi
Hmong	Italian	Japanese	Javanese
Korean	Malay	Mandarin/Chinese	Marathi
Portuguese	Punjabi	Russian	Spanish
Tamil	Telugu	Turkish	Urdu
Vietnamese	Wu	Language Not Listed

How comfortable are you with English?

Would you 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.

Breakthrough History

How did you hear about Breakthrough?

Breakthrough presentationBreakthrough staff memberFamily connectionTeacherBreakthrough studentOtherSelect 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 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?

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

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.

Alaska Native American IndianAsian or Asian AmericanBlack or African AmericanMiddle Eastern or North AfricanMultiracialNative HawaiianPacific IslanderWhite Other Race, not listedDecline to State

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.

None	EL	IEP
504	Accommodation plan	RSP
Other

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.

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. Why would you like your student to be a part of Breakthrough?

Parent Short Response Answer #1

Your answer is required in order to submit.

2. The success of students at Breakthrough SJC, and of our program as a whole, depends on the continual support of family members. How will you support your student and contribute to the Breakthrough community?

Parent Short Response Answer #2

Your answer is required in order to submit.

3. Describe what your child does when he/she gets home from school. Do they have chores? Do they help you take care of siblings? Where and how do they complete their homework?

Parent Short Response Answer #3

Your answer is required in order to submit.

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 recommenders directly via email.

Recommender 1

1. Recommender's Name:

If this name is incorrect or mispelled, please correct under the student section on page 3 of this form.

1a. Recommender's Email:

Recommender 2

2. Recommender's Name:

If this name is incorrect or mispelled, please correct under the student section on page 3 of this form.

2a. Recommender's Email:

Student Academic Records

Upload Student's MFMS Transcript with School Year 2024-2025 Grades:

*Transcripts can be requested from the MFMS main office or accessed through Aeries. Please take a picture of a printed copy of the transcripts and upload it here OR download a PDF version online through Aries and upload transcripts accordingly.

Breakthrough Expectations

Breakthrough San Juan Capistrano is a tuition-free academic enrichment program.

Your child is applying to a 10+ year commitment that includes:

Summer Program: Three intensive six-week summer sessions that occur after their 6th, 7th, and 8th grade school years at St. Margaret’s Episcopal School (Transportation is offered).

Middle School Programming: Academic readiness and enrichment programming during their 7th and 8th grade school years, including:

After-school programing offered once a week at Marco Forster
Attendance of quarter family meetings set for the school year
Sustaining academic excellence and involvement
Responsiveness to all communication from Breakthrough staff

High School & College Programming: On-going support through high school and college, including advising and college counseling, and:

Attendance of quarter family meetings set for the school year
College-bound workshops that prep students for college admissions/graduation
Summer programming as offered for each grade
Sustaining academic excellence and involvement
Responsiveness to all communication from Breakthrough staff

2025 PROGRAM DATES

New Student Orientation: Saturday, May 3, 2025

Summer 2025 Program: June 30, 2025 - August 1, 2025 (8:00 a.m. – 3:45 p.m. | Mon-Fri)

Parents’ Night on Wednesday, July 10, 2025 | 5:30pm-7:30 pm

Conferences on Saturday, July 19, 2025 | 9:00am-12:00pm

Celebration on Saturday, August 2, 2025 | 5:00pm-8:00 pm

School Year 2025-2026: September-May Breakthrough In-Session

1 day x week after school at MFMS

1 meeting X quarter for all families

*Dates are tentative, and subject to change.

Attendance is mandatory: Should your child enroll, you are making a commitment to plan family events around the program dates listed above. Students who are absent from the program for more than three programming dates or events are subject to probation, and prolonged periods of probation can result in the student being dismissed from the program.

By checking the box below, you are acknowledging that you understand the expectations Breakthrough has for its students and families accepted into its program.

Please confirm your commitment by checking the box below.

I understand the expectations of Breakthrough. I/We understand that Breakthrough San Juan Capistrano requires the entire family to make a 10+ Year commitment. Each student MUST attend THREE entire summers (6 weeks each summer) and 10+ school years (7th-12th grades + 4-6 yrs college/university).Your answer is required in order to submit.

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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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