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


Northeastern Ohio Educators

Dear Educators,

 

Thank you for taking the time to refer a student for admission at Boys Hope Girls Hope [BHGH] of Northeastern Ohio. 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:

  • Are motivated to succeed in a rigorous academic environment and possess recognizable determination and grit
  • Perform at or above grade level, show academic motivation, turn in assignments on time and ask for help when needed
  • Are free of significant learning and/or behavior challenges and are open to strengthening their mental, emotional and spiritual wellness
  • Consistently demonstrate integrity, compassion and service towards others as well as possess recognizable leadership potential
  • 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

 

Please complete the form for each child you would like to refer to our program.


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, North Eastern Ohio, San Francisco, St. Louis. Academies deliver direct programming to the scholar cohorts after or during school and on weekends, in a group context marked 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, North Eastern Ohio, Pittsburgh, Southern California, St. Louis. BHGH has clear standards of care, found in the Program Handbook, that ensure that the residential setting is to be applied. 
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 program offers year-round homes for 6th through 12th grade students in a “boarding school” type approach. Bright and motivated students who could use a structured, stable place to work on achieving their dreams come to live at our Campus of Hope while receiving academic scholarships at some of the area’s top Middle and High Schools.



Youth Being Referred








Survey & Short Answers
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.







Primary Parent/Guardian of Youth Being Referred













Consent to be Contacted by Boys Hope Girls Hope