SMART Interest Form

Fields to Hide

Application Status

Type

Class

Teacher Relationship to Student

Who is completing this form?

I am a parent or guardianI am a teacherI am a Community-Based Organization member or Other

Choose your preferred language

Eliga tu idioma preferido

选择您的首选语言

EnglishEspañol中文 (简体)

Please complete this interest form to submit basic information about your applicant. This form is NOT the official SMART application. After filling out this interest form, you will be sent the full online SMART student application by email.

To qualify for SMART, families must meet the below criteria. SMART will verify that families meet these criteria later in the official application process.

If you have questions about meeting eligibility please reach out to us at apply@thesmartprogram.org or 415-814-8594.

SMART Application Eligibility Guidelines:

The student is a current 4th-grade student (2023-2024 school year)
The student will be within the first generation in their family to graduate college (parent/guardian has not graduated from a four-year college in the U.S., but siblings may have).
The student attends the mandatory Summer Program (June–July 2024).
The student’s family meets SMART’s income criteria.

* Household size: all family members for whom you claim financial responsibility for on your federal tax form. If parents file taxes separately, but are both financially responsible, household size refers to the combined number of family members from both tax forms. SMART will be verifying household size and income when collecting federal tax forms with the official SMART application.

Please fill out this form if you are a parent or guardian planning to apply for your 4th-grade student. Applications will be available in January!

Student Info

Student Grade

Please note that your student is a current 4th-grade student during the 2023-2024 school year.

First Name

Middle Name

Last Name

Birthdate

Gender

MaleFemaleNon-Binary or Other

Ethnicity - Is the student Hispanic or Latino?

YesNo

Racial/Ethnic Identification - Please indicate what you consider the student's race by marking one or more of the following boxes.

American Indian or Alaska Native	Asian Indian
Black or African-American	Cambodian
Chinese	Filipino
Guamanian	Hawaiian
Hmong	Japanese
Korean	Laotian
Middle Eastern/Arabic	Other
Other Asian	Other Pacific Islander
Samoan	Tahitian
Vietnamese	White
Not Specified

If Other, please specify:

Parent/Guardian Information

First Name

Last Name

Phone Number

What language do you prefer to receive communication in?

English	Spanish
粤语 (Cantonese)	普通话 (Mandarin)
Tiếng Việt (Vietnamese)	عربي (Arabic)
Other

If Other, please specify:

Teacher Information

Please provide the name and email address of a teacher who can provide a recommendation for your child. SMART will send the recommendation form directly to the teacher.

I currently do have this information, and I understand that SMART will send the recommendation form directly to the teacher whose information I provided.I do not currently have this information, but I understand that I will need this information for the official application in January.

First Name

Last Name

Title

4th-grade teacher3rd-grade teacher

School

If your school is not listed, choose 'Other'

If Other, please specify

Questions? Please contact apply@thesmartprogram.org or (415) 814-8594.

Por favor complete este formulario de interés para entregar información básica de su estudiante. Esta forma NO es la aplicación oficial de SMART. Después de llenar esta forma vamos a enviarle la aplicación de SMART cuando abre en enero.

Para calificar por SMART, las familias deben cumplir los requisitos descritos abajo. SMART va a verificar que las familias cumplen con los requisitos más luego dentro del proceso de aplicación.

Si tienes alguna pregunta o duda sobre su elegibilidad por favor contáctanos a apply@thesmartprogram.org o 415-814-8594.

Requisitos de elegibilidad de la aplicación SMART:

El estudiante es un estudiante actual de cuarto grado (año escolar 2023-24)
El estudiante estará dentro de la primera generación de su familia en graduarse de la universidad (el padre/tutor no se ha graduado de una universidad de cuatro años en los EE. UU., pero es posible que los hermanos sí).
El estudiante asiste al programa de verano obligatorio (junio-julio de 2024).
La familia del estudiante cumple con los criterios de ingresos de SMART.

Tamaño de hogar: Todos los miembros de la familia por los cuales reclama responsabilidad financiera en su formulario de impuestos federales. Si los padres presentan impuestos por separado pero ambos son financieramente responsables, el tamaño del hogar se refiere al número combinado de miembros de la familia de ambos formularios fiscales. SMART verificará el tamaño del hogar y los ingresos al recopilar los formularios de impuestos federales con la aplicación oficial de SMART.

Complete este formulario si es un padre o tutor que planea presentar una solicitud para su estudiante de cuarto grado. Las solicitudes completas estarán disponibles a principios de enero.

Información del estudiante

Grado actual de estudiante

Tenga en cuenta que su estudiante es un estudiante actual de 4to grado durante el año escolar 2023-2024.

Primer nombre

Segundo nombre

Apellido

Fecha de nacimiento

Genero

MasculinoFemeninoNo binario u otro

Origen étnico - ¿El estudiante es hispano o latino?

SiNo

Identificación racial/ etnicidad - Indique cuál considera que es la raza del estudiante marcando una o más de las siguientes casillas

Blanco	Camboyano
Chino	Filipino
Guameña	Hawaiano
Hmong	Indio americano o nativo de Alaska
Indio asiático	Japonés
Koreano	Laosiano
Negro o afroamericano	No especificado
Oriente Medio/Árabe	Otro
Otro asiático	Otro isleño del pacífico
Samoano	Tahitiano
Vietnamita

Si otro, por favor especifique:

Información del padre/madre/tutor

Nombre

Apellido

Correo electrónico

Número de teléfono

En qué idioma prefiere recibir comunicaciones?

Español	Ingles
粤语 (Cantonese)	普通话 (Mandarin)
Tiếng Việt (Vietnamese)	عربي (Arabic)
Other

Si otro, por favor especifique:

Información del maestro

Proporcione el nombre y la dirección de correo electrónico de un maestro que pueda recomendarle a su hijo. SMART enviará el formulario de recomendación directamente al maestro.

Actualmente, tengo esta información y entiendo que SMART enviará el formulario de recomendación directamente al profesor cuya información proporcioné.Actualmente no tengo esta información, pero entiendo que voy a necesitar esta información para el proceso de solicitud en enero.

Nombre

Apellido

Título

Profesor de 4to gradoProfesor de 3er grado

Correo electrónico

Escuela

Seleccione Other si la escuela no se encuentra en esta lista

Si es otro, por favor especifica.

¿Preguntas? Póngase en contacto con apply@thesmartprogram.org o (415) 814-8594.

请填写此兴趣表，提交申请人的基本信息。此表格不是正式 SMART 申请表。填写此意向表后，我们将在一月份开放时向您发送正式 SMART 申请。

要获得 SMART 资格，家庭必须满足以下要求。SMART 将在稍后的正式申请过程中验证家庭是否符合这些要求。

如果您对满足资格有疑问，请通过 apply@thesmartprogram.org 或 415-814-8594 与我们联系。

SMART 申请资格指南：

该学生目前是四年级学生（2023-24 学年）
该学生将成为家庭第一代大学毕业生（父母/监护人没有从美国的四年制大学毕业，但兄弟姐妹可能有）。
该学生必须参加强制性的暑期课程（2024 年 6 月至 7 月）。
该学生的家庭符合 SMART 的收入资格。

* 家庭规模：您在政府税表上声明为其承担经济责任的所有家庭成员。如果父母分别报税，但两人都有经济责任，家庭规模是指两种纳税表中家庭成员的总人数。SMART 将在接受正式 SMART 申请表时收集联邦税表验证家庭规模和收入。

如果您是计划为四年级学生申请的家长或监护人，请填写此表格。完整的申请表将于4月截止。申请将于一月份开放！

学生资料

学生年级

请注意，您的学生是 2023-2024 学年的四年级学生。

名字

中名字

姓

出生日期

性别

男性女性非二进制或其他

种裔 - 学生是否西班牙裔或拉丁裔？

是

否

种 / 族裔 - 请通过标记以下一个或多个框来表明您认为学生的种族

美洲原住民或阿拉斯加原住民	印度人
黑裔或非裔美国人	高棉人/柬埔寨
中国人	菲律宾人
关岛人	夏威夷人
大溪地人	越南人
苗族人	日本人
韩国人	老挝人
中东/阿拉伯人	其他亚洲人
其他太平洋岛民	萨摩亚人
白人	未指定
其他

如果是其他，请说明：

家长/监护人资料

名字

姓

电子邮件

电话号码

您想用哪种语言接收通讯？

英语	西班牙语
中文 - 广东话	中文 - 普通话
越南语	阿拉伯语
其他

如果是其他，请说明：

老师资料

请分享可以为您的孩子提供推荐的老师的姓名和电子邮件地址。SMART 会将推荐表直接发送给老师。

我目前确实有这些信息，并且我了解 SMART 将直接向我提供的老师发送推荐表格。我目前没有此信息，但我知道我在一月份的正式申请中需要此信息。

名字

姓

职称

4年级教师3年级教师

电子邮件

学校

如果学校不在此列表中，请选择 Other

如果是其他，请说明：

感谢您填写我们的兴趣表！我们期待在一月份通过电子邮件向您发送申请表。如果您有任何疑问，请通过 apply@thesmartprogram.org 或 415-814-8594 与我们联系。

Thank you for your interest in supporting a 4th-grade student to apply for SMART!

To qualify for SMART, families must meet the below criteria. SMART will verify that families meet these criteria later in the application process. If you are a nominating teacher and not sure if a family qualifies, please nominate the student and SMART will follow up with the family. Please click on this link for more information on our program.

SMART Application Eligibility Guidelines:

The student is a current 4th-grade student (2023-24 school year)
The student will be within the first generation in their family to graduate college (parent/guardian has not graduated from a four-year college in the U.S., but siblings may have).
The student attends the mandatory Summer Program (June–July 2024).
The student’s family meets SMART’s income criteria.

Please fill out this form if you are an educator nominating a 4th-grade student to SMART. You may nominate as many students as you'd like.

Teacher Information

Please provide your information, so that SMART can send you a recommendation form.

First Name

Last Name

Phone Number

Title

School

If your school is not listed, choose 'Other'

If Other, please specify

Student Info

Student Grade

Please note that your student is a current 4th-grade student during the 2023-2024 school year.

First Name

Middle Name

Last Name

Birthdate

Gender

MaleFemaleNon-Binary or Other

Ethnicity - Is the student Hispanic or Latino?

YesNo

Racial/Ethnic Identification - Please indicate what you consider the student's race by marking one or more of the following boxes.

American Indian or Alaska Native	Asian Indian
Black or African-American	Cambodian
Chinese	Filipino
Guamanian	Hawaiian
Hmong	Japanese
Korean	Laotian
Middle Eastern/Arabic	Other
Other Asian	Other Pacific Islander
Samoan	Tahitian
Vietnamese	White
Not Specified

If Other, please specify

Parent/Guardian Information

First Name

Last Name

Phone Number

Preferred Language

We send written communication to the family in the language indicated.
If you select 'Other', written communication may still be sent in English.

If other, please specify the language

Letting Families know about SMART

You would like SMART to inform families they have been nominated.You plan to notify the family OR have notified the family that they have been nominated for SMART.

Questions? Please contact apply@thesmartprogram.org or (415) 814-8594.

Thank you for your interest in supporting a 4th-grade student to apply for SMART!

SMART Application Eligibility Guidelines:

The student is a current 4th-grade student (2023-24 school year)
The student will be within the first generation in their family to graduate college (parent/guardian has not graduated from a four-year college in the U.S., but siblings may have).
The student attends the mandatory Summer Program (June–July 2024).
The student’s family meets SMART’s income criteria.

Please fill out this form if you are an educator nominating a 4th-grade student to SMART. You may nominate as many students as you'd like.

Nominator Information

Please provide your information, so that SMART can send you a recommendation form.

First Name

Last Name

Phone Number

Title

Organization

Relationship to Student

Community Organization/MemberOther

If Other, please specify

Student Info

Student Grade

Please note that your student is a current 4th-grade student during the 2023-2024 school year.

First Name

Middle Name

Last Name

Birthdate

Gender

MaleFemaleNon-Binary or Other

Ethnicity - Is the student Hispanic or Latino?

YesNo

Racial/Ethnic Identification - Please indicate what you consider the student's race by marking one or more of the following boxes.

American Indian or Alaska Native	Asian Indian
Black or African-American	Cambodian
Chinese	Filipino
Guamanian	Hawaiian
Hmong	Japanese
Korean	Laotian
Middle Eastern/Arabic	Other
Other Asian	Other Pacific Islander
Samoan	Tahitian
Vietnamese	White
Not Specified

If Other, please specify

Parent/Guardian Information

First Name

Last Name

Phone Number

Preferred Language

We send written communication to the family in the language indicated.
If you select 'Other', written communication may still be sent in English.

If other, please specify the language

Letting Families know about SMART

You would like SMART to inform families they have been nominated.You plan to notify the family OR have notified the family that they have been nominated for SMART.

Questions? Please contact apply@thesmartprogram.org or (415) 814-8594.

Contact Information