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GEAR UP Cover-sheet Form

Unique ID
Person submitting this sign-in sheet:
Date this sign-in sheet was submitted to Edstar
Date Format: MM slash DD slash YYYY
How was the sign-in sheet submitted?
- Email
- Secure upload site
Email subject line
Date the service took place*
Date Format: MM slash DD slash YYYY
District
Select a school, District 1
Select a school, District 2
Select a school, District 3
Was this kicked back?
- Yes
- No
Date of Kickback
Date Format: MM slash DD slash YYYY
Subject line of kicked back email
Notes on why it was kicked back. (Stop here.)
Person (s) serving as staff at this event:
Does this include an entire grade?*
- No
- Yes
Grades Served
- 10
- 11
- 12
- 13
Select the Service*
- 21st Century Scholars
- 529 Savings Account
- Academic Remediation-Summer
- Academic Remediation-CCRG
- ACT/Pre-ACT Prep
- ACT Retakes
- ASPIRE Day-Financial Aid
- ASPIRE Day-Counseling
- ASPIRE Day-College Visit
- Career Fair
- College Application Week-Financial Aid
- College Application Week-Counseling
- College Decision Day
- College Visit
- Counseling Advising
- Credit Recovery
- Financial Aid
- Finish the FAFSA
- GEAR UP for College Week-Financial Aid
- GEAR UP for College Week-Counseling
- Information Distribution-Counseling
- Information Distribution-Financial Aid
- Job Shadow
- Mentoring
- One-on-One Counseling
- One-on-One Financial Aid
- One-on-One Mentoring
- Post Secondary-BOT
- Post Secondary-General
- Senior Day-Financial Aid
- Senior Day-Counseling
- Tutoring/HW Assistance-Math
- Tutoring/HW Assistance-English
- Tutoring/HW Assistance Both Math & English
- Tutor.com-Math
- Tutor.com-English
- Tutor.com-Math & English
What college did they visit?
- Alamance Community College
- Appalachian State
- Asheville-Buncombe Technical
- Barton College
- Beaufort County Community College
- Bennett College
- Bladen Community College
- Blue Ridge Community College
- Brevard College
- Caldwell Community College
- Campbell University
- Catawba College
- Central Carolina Community College-Charlotte
- Central Carolina Community College-Chatham
- Central Piedmont Community College
- Chowan University
- College of the Albemarle
- Craven Community College
- Davidson College
- Davidson County Community College
- Duke University
- Durham Technical Community College
- East Carolina
- Edgecombe Community College
- Elizabeth City State
- Elon University
- Fayetteville State
- Fayetteville Technical Community College
- Forsyth Technical Community College
- Gardner Webb University
- Gaston College
- Greensboro College
- Guildford Technical Community College
- Guilford College
- GUILFORD TECHNICAL COMMUNITY COLLEGE
- Halifax Community College
- Haywood Community College
- High Point University
- Isothermal Community College
- James Sprunt Community College
- Johnson C Smith University
- Johnston Community College
- Lees-McRae College
- Lenoir Community College
- Lenoir–Rhyne University
- Livingstone College
- Louisburg College
- Mars Hill College
- Martin Community College
- Mayland Community College
- McDowell Technical Community College
- Meredith College
- Methodist University
- Mitchell Community College
- Montgomery Community College
- Montreat College
- Nash Community College
- NC Agricultural and Technical State University
- NC Central University
- NC State University
- North Carolina Wesleyan College
- Other - Out of State
- PAMLICO COMMUNITY COLLEGE
- Piedmont Community College
- Pitt Community College
- Randolph Community College
- Richmond Community College
- Robeson Community College
- Rockingham Commnity College
- Saint Andrews University
- Saint Augustine's University
- Salem College
- Sandhills Community College
- Shaw University
- Southeastern Community College
- Southwestern Community College
- Stanly Community College
- UNC Asheville
- UNC Chapel Hill
- UNC Charlotte
- UNC Greensboro
- UNC Pembroke
- UNC School of the Arts
- UNC Wilmington
- University of Mount Olive
- Vance Granville Community College
- Wake Forest University
- Wake Technical Community College
- Warren Wilson College
- Western Carolina
- Western Piedmont Community College
- Wilkes Community College
- William Peace University
- Wilson Community College
- Wingate University
- Winston-Salem State
Financial Aid (Hidden)
Mentoring (Hidden)
Counseling Advising (Hidden)
Post-Secondary (Hidden)
Tutoring (Hidden)
Supportive Services (Hidden)
College Visit (Hidden)
Job Shadow (Hidden)
Hours of service (whole number)*
Minutes of service (whole numer)*
Modality
How many students?
Were family members present?
- Yes
- No
Initials*
Original file name:
Notes

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