Personal Information
Would you like to receive text messages?:
Ethnicity (Please check all that apply to you) :

Are you a U.S. Citizen?:
A copy of the Permanent Resident Card will be required.


Family Information
Do either of your biological parents have a 4-year college degree?:

Please note: if you only live with one parent then please enter "N/A" in the fields that dont apply.

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Income Documentation

The Federal Government requires that we collect income information to ensure we are following the grant program guidelines. A copy of your annual federal tax form is required with this application.

Do you recieve free or reduced lunch?:
Is the applicant a ward of the court? :
Did your family receive non-taxable income (check all that apply):


Educational Plans
Are you thinking about going to college? :


Verification and Release of Information

In addition to the information in this application, Upward Bound will need to request information from other sources and share information with other sources, in order to meet the grant guidelines and provide the best possible service for your child. Your signature below indicates that we may:

  1. Communicate with your high school counselor and other instructors.
  2. Request a copy of your middle, high school, college transcript and test scores for your school and district.
  3. Request a copy of your SAT and/or ACT rest scores.
  4. Use your Social Security Number to request a copy of your financial aid application, transcripts, college enrollment status, and awards from the federal & state funding agencies, post-secondary institutions, and the National Student Clearinghouse.
  5. Communicate with representatives from agencies or post-secondary institutions on your behalf.

I hereby authorize Upward Bound to contact and request information from, as well as to share information with the above mentioned parties.

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