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Alumni Update
Hello UB alumni! Our office would love to know what you've accomplished since leaving Upward Bound. Please fill out the form below with your most recent information, which the UB staff will keep confidential. If any required questions do not apply to you, please put "N/A." If you encounter any issues with submitting the form, please contact us at
upward_bound@hmc.edu
. Thank you!
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* Indicates required question
Personal Information
Name
*
First and last name
Your answer
Name Change (If applicable)
Maiden name, legally changed name, ect.
Your answer
UB Class of
*
Graduation Year
Your answer
High School
*
What UB high school did you graduate from? (If you graduated from a non-UB high school, please state what UB high school you were recruited from.)
Your answer
While in high school, list any other programs you were serviced by:
*
Example: TS, Gear Up, EOC, ect.
Your answer
Email
*
Your answer
Would you like to be added to our email list?
*
Be informed of any alumni events, calls for action, or UB needs.
Yes
No
Cell Phone
Your answer
Permanent Address
Street Address
Your answer
Permanent City
Your answer
Permanent State
Your answer
Permanent Zip
Your answer
Current Address (if different from perm address)
Street Address
Your answer
Current City
Your answer
Current State
Your answer
Current Zip
Your answer
Postsecondary Education Information
Undergraduate College or University
*
Currently attending or attended
Your answer
Date of First Enrollment
*
Example: Fall 2010
Your answer
Gap Semesters
Your answer
Enrollment Status
*
Full Time
Part Time
Graduated
Leave of Absence
Postsecondary Remediation (First year only)
*
Check all that apply
Yes, I received college level math remediation.
Yes, I received college level english remediation.
No, I wasn't enrolled in any remediation class.
Required
Major
*
Your answer
Minor
Your answer
Currently College Grade Level
*
Freshman
Sophomore
Junior
Senior
Graduated
Academic Standing
*
Good
Fair
Academic Probation
Certificate or Degree Completed
*
Your answer
Year Graduated
*
(if applicable)
Your answer
Other College or University's Attended
*
Your answer
Enrollment Dates
*
Of other college or university's attended
Your answer
Graduate School Information
If Applicable
College or University Name
Your answer
Date of First Enrollment
Example: Spring 2011
Your answer
Program of Studies
Your answer
Enrollment Status
Full Time
Part Time
Graduated
Leave of Absence
Clear selection
Degree Completed
Your answer
Work/Occupation
Current Occupation
Your answer
Company/Organization
Your answer
Misc
Please tell us what your best UB memory is.
Your answer
Would you like to participate as a UB mentor?
*
Example: College tour guide, college/career panels, ect.
Yes
No, thanks
Maybe
Would you like to be profiled on the HMC Upward Bound website?
*
Yes
No, thanks
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