UVa-Wise Upward Bound Student Application
READ CAREFULLY

It is recommended that you use either the Firefox or Chrome internet browser to complete this application.

The application should be completed in one sitting - it cannot be saved.

Both the student and at least one parent/guardian must provide information throughout the application.

Before you begin, make sure you have the following information at hand:
- Applicant's mailing address
- Family household size
- Taxable income amount from family's most recent federal tax return (Line 10 on Form 1040)
- SNAP/TANF case numbers (if applicable)
- Sources of other income (if family did not file taxes)
- Highest level of education attained by both the applicant's father & mother

The application also contains 2 short essay questions for the applicant (roughly a paragraph each).

Thank you for your interest in our UB program! Contact us at upwardbound@uvawise.edu with any questions!
Upward Bound Non-Discrimination Policy
TITLE IX: UVa-Wise (the “College”) is committed to maintaining a respectful, professional and nondiscriminatory academic, living and working environment for students, faculty, staff, and visitors. This includes maintaining an environment free from harassment and discrimination for everyone and does not discriminate on the basis of a person’s race, gender, ethnicity, national origin, religion, age, pregnancy or parenting status, disability, or other protected status. This includes having an environment free from sexual and gender-based harassment, sexual assault, intimate partner violence, stalking, sexual exploitation, complicity and retaliation. For more information contact Tabitha Smith, Title IX Coordinator, Office of Compliance Conduct, and Inclusion (tabitha.smith@uvawise.edu). The College’s full Sexual Misconduct Policy and grievance procedures are available at www.uvawise.edu/compliance/files/compliance/UVaWise_SexualMisconductPolicy.pd

CAMPUS SECURITY-CLERY ACT: UVa-Wise is committed to helping the campus community provide for their own safety and security. The Annual Security Report and Fire Safety Report containing information on campus security and personal safety, including alerts, fire safety, crime prevention tips, and crime statistics is available at www.uvawise.edu/ASR. A copy is available upon request by calling 276-328-0190 or 276-376-3451.

The personal information provided on this application is required for reporting purposes to the Federal Government and is protected under the Privacy Act.
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