REACHing MAGIS Program Referral Form 2024
REACHing MAGIS
is a program for 5th through 8th graders to help prepare them for the academic, social and spiritual challenges they may encounter as students in a college
preparatory high school setting.
The Le’Charles Bentley 5th Grade Leadership Academy
will support 35 future leaders from the Greater Cleveland Area who a
ttend Catholic, Private, and Public schools.
Student Contact Information
Student Name:
School:
Faith Community (if known):
Home Street Address:
City/Zip Code:
Home Phone Number (with area code):
Parent Email Address
Referrer's Contact Information
Name:
Position:
Email Address
Home or Business Address:
City/Zip Code:
Home or Daytime Phone Number (with area code):
Student's Academic Profile
Typical Grades (please select one):
A
A-B
B
B-C
C or lower
Student's Grade Level (2023-2024 school year):
4th
5th
6th
7th
Additional comments:
Standardized Testing
Test Format:
CAT
Iowa
Stanford
Other
If "other", please enter test name:
Math National %:
90-99
70-89
50-69
Below 50
Unknown
Reading National %:
90-99
70-89
50-69
Below 50
Unknown
English National %:
90-99
70-89
50-69
Below 50
Unknown
Additional comments:
I am referring the student listed above because he is an African American, Latino, Asian American, Native American (AALANA) or Caucasian young man who has demonstrated academic and social potential and a commitment to grow spiritually. I believe the information provided above to be accurate.
Contact Information