Upward Bound Application 2020

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ALL applications will be reviewed on a first-come, first serve basis until our grant number is met
(late applications will be kept on file)

Please be prepared with all necessary information in order to complete form in one sitting.

***Information needed to complete application***
Students:
Email address of a teacher, counselor, or mentor (an adult who is not related to you) who can recommend you for the program

Short Answer and Essay Responses
(It may be useful to type this ahead of time in another place and copy to the form.)
For the short answer responses, please write 2-3 complete sentences.
1. How will a college degree help you become the person you want to be in the future?
2. Why do you want to go to college?
3. What kinds of academic struggles do you feel you have? What classes?
4. Why do you want to be in Upward Bound?
Write a short essay answering the writing prompt below with a minimum of 75 words:
Based on your personality, goals, and past experiences, how will you be a thriving member of our Upward Bound family?

Parent/Guardian:
Tax Information
Education Level of Parent(s)/Guardian(s)

Email *

Name *

YYYY

Grade *

Sex *

Female

Male

Phone Number *

Address Line 1 (Street Number, Street Name) *

Address Line 2 (Optional)

City *

State *

Zip Code *

What is your citizenship status? *

U.S. Citizen

Permanent Resident

How do you describe your ethnicity? *

American Indian or Alaskan Native

Asian, Asian American/Pacific Islander

Black

Latinx/Hispanic Origin

White

Other:

Required

Name of School *

South Beloit

Beloit Memorial

Other:

Name of Guidance Counselor *

G.P.A. (if just starting high school, give 8th grade G.P.A.) (if unknown, put "NA") *

In eighth grade, I received...

Answer if you responded "NA" to the previous question.

Mostly As and Bs

Mostly Bs and Cs

Mostly Cs and Ds

Mostly Ds and Fs

Other:

Clear selection

Extra Curricular Activities/Hobbies/Sports *

Provide an email address for one teacher, counselor, or mentor (an adult who is not related to you) who will be emailed a Nominator Form to complete for you (please make sure to tell the person!) *

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