Application Procedure

Follow these nine steps to complete your application. Please make sure that you do not leave any questions blank throughout the whole application. If any of the questions do not apply to you, put N/A (Not Applicable).

  1. Fill in your personal and educational information.

  2. Fill in your family information.

  3. Write a brief essay on how you hope to benefit from Upward Bound, sign it and ask your counselor/principal to complete the bottom page.

  4. Ask your parent(s) or guardian(s) to read and sign the Parent(s) Contract of Participation. You need to read and sign the Student Contract of Participation.

  5. With the help of your parent(s)/guardian(s), please complete the Media Release.

  6. Ask your teacher/counselor to complete the Evaluation Form

  7. Ask your parent(s) or guardian(s) to fill out and sign the Income Statement. You will also need to submit one of the following: Income Verification--a copy of your recent tax return Form 1040 or 1040EZ, or a letter from the Department of Transitional Assistance and/or Social Security documenting your family income.

  8. You and your parent(s)/guardian(s) should sign the last page declaring that the information provided is true to the best of his/her knowledge.

  9. Please ask your guidance counselor for a copy of your complete high school transcript. If a student is enrolled in special education course(s) a current copy of his or her Individual Education Plan must accompany the application.

Thank you for your interest in the Upward Bound Program. As soon as we receive your completed application, we will schedule an interview with you. We believe that Upward Bound offers an exciting opportunity for you to work toward your future educational goals, and we look forward to working with you to achieve those goals.

To apply, or for more information contact John O. Anene at (937) 376 – 6496 or via email or


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