Participant Referral Form

Instructions

Welcome! To refer a young person to Boys Hope Girls Hope, please complete and submit this form. If you would like to refer more than one person, please complete the form once for each referral.


Si prefiere completar este formulario en español, imprime aqui: 

PPM-Referencias (bhghforms.org)

Your Contact Info



Detailed Referral Information





















Boys Hope Girls Hope Programs
The Academy Program provides college prep and other enriching activities after-school and during the weekend to scholars who attend our partner schools in Arizona, Colorado, Detroit, Guatemala, New York, Northeastern Ohio, and St. Louis. Academies deliver direct programming to the scholar cohorts by the same empowering environment as in the residential program. 

The Residential Program offers a "live-in" college readiness option to scholars who meet certain criteria and need. All homes are licensed and operate in compliance with their appropriate state and local government entities in: Arizona, Baltimore, Cincinnati, Detroit, Guatemala, Illinois, Kansas City, New Orleans, New York, Northeastern Ohio, Pittsburgh, Southern California, and St. Louis. Boys Hope Girls Hope has clear standards of care as described in our Policy Manual. 
Northeastern Ohio BHGH Programs
BHGH has two programs on its Campus of Hope located in Garfield Heights.

 

The first is our Academy Program. This program offers year-round ‘out-of-school’ time programming for 6th-12th grade students that takes place in the evenings, on weekends and in the summer. This program focuses on academics, character, life skills and college & career planning. If you are an educator who has been asked by a BHGH staff member to nominate 5th grade students, please select ‘Academy.’

 

The second is our Residential Program. This unique program provides promising students with a fully funded residential experience, holistic support and 100% tuition scholarships to attend Northeast Ohio's most rigorous schools.


Northeastern Ohio Academy Program

Dear Educators,


Thank you for taking the time to refer a student for admission at Boys Hope Girls Hope [BHGH] of Northeastern Ohio Academy Program. This form typically takes 10-15 minutes to complete.


Founded in 1986, BHGH has been providing high-potential young people in need with a unique 10-year partnership beginning in middle-school and continuing through career launch. Admitted Scholars receive intensive support through year-round after-school, evening, weekend and summer programs.


Qualified Referrals:


MOTIVATION: Are motivated to succeed in a rigorous academic environment and possess recognizable determination and grit


ACADEMICS: Perform at or above grade level, show academic motivation, turn in assignments on time and ask for help when needed


WELLNESS: Are free of significant learning and/or behavior challenges and are open to strengthening their mental, emotional and spiritual wellness


CHARACTER: Consistently demonstrate integrity, compassion and service towards others, positively relates to adults and peers & possess recognizable leadership potential


NEED: Come from families that are committed to partnering with BHGH for their child’s holistic growth and academic success and maintain a household income that is generally at or below 200% of the federal poverty guideline

Northeastern Ohio Residential Program

Thank you for taking the time to refer a student for admission at Boys Hope Girls Hope [BHGH] of Northeastern Ohio Residential Program. This form typically takes 15-20 minutes to complete.


Scholars enrolled in our Residential Program attend outstanding private middle and high schools whose missions reflect the same holistic values that BHGH was founded upon. Residential scholars live in one of three homes on our campus in Garfield Heights. The homes are staffed by a qualified and highly trained group of dedicated Residential Counselors who have answered the vocational call to live-in community with these young people.


Qualified referrals have a need for a long-term nurturing “home away from home” that offers opportunity and prevention as well as:


AGE: Are typically between the ages of 11 and 14


MOTIVATION: Are motivated to succeed in a rigorous academic environment and possess recognizable determination and grit


ACADEMICS: Perform at or above grade level, show academic motivation, turn in assignments on time and ask for help when needed


WELLNESS: Are free of significant health, learning and/or behavior challenges and are open to strengthening their mental, emotional and spiritual wellness


CHARACTER: Consistently demonstrate integrity, compassion and service towards others, positively relates to adults and peers & possess recognizable leadership potential


NEED: Come from families that are committed to partnering with BHGH for their child’s holistic growth and academic success and maintain a household income that is generally at or below 200% of the federal poverty guideline


Youth Being Referred








Survey & Short Answers

Boys Hope Girls Hope Northeastern Ohio Academy Questions


Student Academic, Motivation & Behavior Survey - For each question, please think about how the child is in most situations when compared to their peers.









Short Answers - Your responses to the following help us to "get to know" the student you feel would benefit from this program. Please note, your responses are are kept confidential by our Admissions Committee







Boys Hope Girls Hope Northeastern Ohio Residential Questions


Short Answers - Your responses to the following help us to "get to know" the student you feel would benefit from this program. Please note, your responses are are kept confidential by our Admissions Committee.








Primary Parent/Guardian of Youth Being Referred













Consent to be Contacted by Boys Hope Girls Hope