Regional Center for Math and Science      Regional Center for Math and Science

Student Reference Form

Dear Reference: The student requesting you complete this reference is applying for
acceptance into the Regional Center for Math and Science summer program at the University of
Wisconsin-Green Bay in Green Bay, Wisconsin. Before you complete this reference form you may find
the following program information helpful.

The Regional Center for Math and Science, RCMS, is a joint project of the
University of Wisconsin-Green Bay (UWGB) and the U.S. Department of Education.
RCMS resides under the TRIO umbrella as an Upward Bound Math Science program.
We serve the following high schools, also listed on our website

Urban target high schools
  • Wayne Memorial HS, Detroit area (Wayne, MI)
  • Ypsilanti Community HS, Ypsilanti, MI
  • Patrick Henry HS, Minneapolis, MN
  • South Minneapolis HS, MN
  • John Marshall HS, Rochester, MN
  • Century HS, Rochester, MN
  • Appleton West HS, Appleton, WI
  • Rufus King HS, Milwaukee, WI
  • Ronald Reagan HS, Milwaukee, WI
  • South Division HS, Milwaukee, WI
  • Preble HS, Green Bay, WI
  • Southwest HS, Green Bay, WI
WI Rural target area schools
  • Kaukauna HS, Northeast WI (Kaukauna)
  • Lincoln HS, Northeast WI (Manitowoc)
  • Menasha HS, Notheast WI (Menasha)
  • Sparta HS, Southwest WI (Sparta)
  • Stevens Point Area HS, Central WI (Stevens Point)
  • Tigerton HS, North Central WI (Tigerton)
  • Tomah HS, Southwest WI (Tomah)
  • Wittenberg-Birnamwood HS, Central WI
The purpose of the program is two-fold:
  1. to increase high school students' skills in math and science
  2. to encourage low income and/or first generation college students to
    prepare for professional careers in math and science while still in high school.

RCMS is a six-week summer residential experience. Students live in university dorms,
eat in the dining hall, attend classes in the mornings, and participate in faculty
research projects in university laboratories in the afternoons. The RCMS program
includes weekly local field trips, weekend area field trips, and a weeklong stay at
an outdoor science education camp in Northwest Wisconsin. In addition, participants
engage in structured recreational and social activities. All student expenses, including
transportation to and from RCMS, are paid for by a grant from the U.S. Department of
Education. There are no costs to students.

Participation in RCMS is restricted to current high school freshman and sophomores
who meet federal eligibility criteria of coming from a low-income household and/or being
a first generation college student. Eligible students should be motivated to follow a rigorous
academic program for the six weeks in the summer and have the maturity, independence, and willingness
to live away from home. A selection committee reviews all applicants, and the process is competitive.
Therefore, recommendations that provide better detail and insight help the applicant score better.
Upon acceptance, students participate in program activities during the school year and summer until
they graduate from high school.

Last First
APPLICANT ID CODE (Required if submitting online)


Name of Reference


Phone Number

E-mail Address

Mailing address of Reference




Describe your relationship to the student.
In what capacity do you know the student?
How long you have known the student?
How well do you know the student?

Discuss both the academic abilities and potential of the student.
Mention any issues with attendance or study habits.

The RCMS program is a continuous 6-week residential program in Green Bay, WI.
Discuss the student’s maturity level and independence in attending such a program
and being away from home for the 6-weeks.

Describe the personal and social characteristics of the student.
How well do you think the student would fit into the RCMS program given
the two main program objectives listed above?

In your opinion, in what ways would the student potentially benefit from attending this program?
Please indicate below any of the statements that describe the student’s
need for a program like RCMS.

Areas of Need:
Low proficiency scores on state tests
Low high school GPA
At the beginning of 10th grade, had not successfully completed pre-algebra or algebra course
Low educational aspirations
Lack of opportunity, support, and/or guidance to take challenging college prep courses
Lack of career goals and/or need for accurate information on careers
Limited proficiency in English
Lack of confidence, self- esteem, and/or social skills
Predominately low income community
Rural isolation
Interest in careers in math and science
          Other Need (specify):
Comment on any reservations you might have in recommending this student
for the RCMS program.

Recommend with no reservations
Recommend with some reservations
I have strong reservations
          If you selected Recommend with some reservations - Please Explain:
          If you selected with STRONG reservations - Please Explain:
Please provide additional comments that you feel will assist the selection
committee with their decision to select the applicant for participation.