You have been asked to complete this form because of your professional relationship with a teen who has applied to Beyond Akeela. We have already obtained parental consent for our communication. If you would prefer to speak with us by phone, in lieu of completing this form, please let us know by phone (617-882-2267) or email (kevin@campakeela.com).

Beyond Akeela is a 2.5 week overnight summer program for neurodivergent teens who are working on their college readiness as their post-secondary education approaches. Our mission is to provide our teens with a summer filled with fun, social development, and personal success and growth. Our focus is on the essential non-academic skills needed to thrive in college settings: social skills, independent living skills, executive functioning, and self-advocacy. Skill development at Beyond Akeela comes through intentional practice and experiential learning, with structure and scaffolding provided by an experienced and well-trained group of staff members.

Camper Name *

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Your Name: *

First

Last

Email *

In what capacity do you interact with/observe this teen? *

How frequently do you interact with/observe this teen? How long have you been working with them? *

1. What do you find most enjoyable about this teen? *

2. How would you describe this teen's interactions with their peers? How do peers respond to them? *

3. What situations (socially or otherwise) are particularly challenging for them to navigate?

4. Successful Beyond Akeela teens can navigate camp life (eg. hygiene, social emotional relationships, participation) without consistent 1:1 support from a staff member. What coping skills/strategies is this teen able to implement in challenging moments? *

5. What type of adult support does this teen need to regroup and rejoin after a difficult moment? About how much time is the support typically needed? *

6. How frequently is this support necessary (eg. daily, weekly, monthly)? *

7. To your knowledge, has this teen ever been aggressive, self-injurious, threatened or idealized about suicide? *

8. Do you envision this teen being successful in a residential, socially immersive setting, without the "comforts of home", knowing they will be around a like-minded peer group and have scaffolded support from a well-trained seasonal staff? *

9. Is there anything else you'd like to share with us about this teen? *

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