Upward Bound is a program funded by the U.S. Department of Education.  The purpose of Upward Bound is to identify, recruit, and select high school students with academic potential who meet federal eligibility guidelines.  The Upward Bound Program will enhance academic achievement in high school and prepare participants to enter post-secondary education (Universities, Colleges, Vocational/Technical Schools).

Upward Bound participants attend academic enrichment workshops, educational field trips, cultural activities, tour various colleges and universities, and receive academic support through tutors, faculty and staff.

Upward Bound students must successfully complete one six-week summer residential session on the FVSU campus to be eligible for continuation in the program. The summer program simulates a college environment at no cost to the student. The summer includes hands-on interactive enrichment classes that include math, science, English, foreign language, and other exciting elective courses. Students also participate in social and cultural enrichment activities, field trips, wellness and fitness activities, and a host of other exciting activities. 

What may a student expect to gain from being in the Upward Bound Program?

●      Preparation for college, including information on how to obtain financial aid, how to be admitted to college, tips on test taking, and preparation for standardized and college entrance tests

●      Improvement in grades

●      The opportunity to make friends with others from area high schools

●      Academic and career counseling

●      Cultural and social enrichment activities

●      Guidance in making decisions on educational goals

All Upward Bound Services are FREE to participants.

For questions or additional information, please contact us at: 

Upward Bound Program

Fort Valley State University

1005 State University Drive

Fort Valley, GA 31030

Phone: (478) 825-6963

Fax: (478) 825-6131

Website: http://www.fvsu.edu/admissions/upward_bound

Applicants will be selected for program participation in compliance with the provisions of Section 427 of the U.S. Department of Education’s General Education Provisions act (GEPA).  Accordingly, access and participation will not be denied to applicants based on gender, race, national origin, color, or disability.

Complete this application and submit the following documents:

ONE school counselor recommendation is required.

Please copy and share the link with a school counselor and request them to fill out the recommendation form for you.

Counselor Recommendation Form
https://botform.compansol.com/201807487299064

ONE math or science teacher recommendation is required.

Please copy and share the link with a teacher and request them to fill out the recommendation form for you.

Teacher Recommendation Form
https://botform.compansol.com/201807256827055

In addition to these, please ensure to complete ther following:

• Household Income Verification Statement (see section titled "Income Information")
• Medical History Form (see section titled "Medical History Form")
• Signed Consent of Release of Academic Records (see section titled "Consent of Release of Academic Records")

**These forms must be completed and submitted before a student is considered for admission.

Once all forms are received, including a copy of the income documentation, the Upward Bound Office will contact the applicant to advise him/her of admission status.  It is the applicant’s responsibility to ensure that the application package is completed.

 

CONFIDENTIALITY OF INFORMATION

The personal information you give Upward Bound is required by the United States Department of Education.  The information is protected by the Federal Education Right to Privacy Act (FERPA).  No one may see the information unless she/he is employed by the Upward Bound Program or is specifically authorized to determine your eligibility to participate in the program.  The information required by the U.S. Department of Education is used for evaluation purposes and to verify student eligibility. 

Information or records relating to individual Upward Bound students or group(s) of students, who are participating or have participated in Upward Bound projects, will not be disclosed to any person, group, agency, or organization without further written permission from each student, parent or legal guardian.

In order to ensure compliance with the confidentiality guidelines previously explained, please sign and date in all the appropriate places on the Authorization of Information and Release forms.

I understand that these records are confidential and will only be used internally for program participation, selection and academic evaluation.  I also understand that compiled records may be used exclusively to meet the U.S. Department of Education regulations and program evaluation.

None of my identified, individual records will be released to any person, corporation, or organization without further written consent.

Disclosure Statement:

State and federal law protects the privacy of your records.  Providing your social security number is voluntary.  If you provide it, the Upward Bound Program and Fort Valley State University will use it for record-keeping purposes, planning, research and program improvement. Upon request, it will be made available to appropriate governmental sources in order to meet state and federal reporting requirements and for the collection of aggregate statistical information.   The United States Department of Education requires Upward Bound at Fort Valley State University to report on your child’s academic progress through either his or her graduation from college or for at least six years after your child’s high school graduation.

(Please Read Carefully Before Signing)

RELEASE AND WAIVER OF LIABILITY

The undersigned hereby acknowledges that his/her child’s participation in some academic and recreational activities involves an inherent risk of physical injury and by the execution of this signed document release employees of the FVSU Upward Bound Program, Fort Valley State University and the Board of Regents of the University System of Georgia from all claims for injury or damages arising out of said student’s participation in all program-related activities that include but is not limited to intramural and recreational activities, and field trips for which the Upward Bound Project has made available.

 

Transportation Release

I authorize and permit my child to participate in any field trips, activities, workshops, meetings, and events sponsored by or conducted by Fort Valley State University's (FVSU) Upward Bound program. I understand that my child will be transported by Fort Valley State University's approved transportation vendors, Upward Bound staff, or other Fort Valley State University staff.

On my behalf, and behalf of my children, I hereby release, covenant not to sue, discharge, and hold harmless Fort Valley State University, the University System of Georgia, the Georgia Board of Regents, the Upward Bound Program, including each entity's directors, employees, agents, and representatives, of and from the claims, including all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating to any Upward Bound field trip, activity, workshop, meeting, or event. I understand and agree that this release includes any claims based on the actions, omissions, or negligence of Fort Valley State University's- Upward Bound Program, its governing board, directors, employees, agents, and representatives.

 

Internet Release

I authorize and permit my child to participate in Internet research, study, and develop a web page during activities, workshops, meetings, and events sponsored and conducted by the Fort Valley State University’s Upward Bound program. I understand that my child may access the Internet, set up an e-mail account, and design a web page. The students will complete online safety and internet security training before participating in any online project. I further understand that student violation of Internet use is cause for dismissal from the Upward Bound program.

 

MEDICAL AUTHORIZATION

The law requires that before medical services can be performed, permission of the parent(s)/guardian(s) must be obtained.  In the event of serious illness or accident, every effort will be made to contact you.  However, in the event that a delay in medical or surgical treatment might be detrimental to the health of the student, authorization for consultation and treatment by medical personnel is requested.

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I understand that in the event of an accident or illness, all actions of the Upward Bound staff will be guided in the best interest of my child. I hereby authorize Fort Valley State University to obtain the services of a qualified physician of its choice and to use local hospitals and clinics for the treatment of emergency illness or accident if the university considers such action necessary and to sign, as a competent adult, forms permitting examination and possible treatment.  This authorization will be in effect any time my son/daughter is participating in an Upward Bound sponsored activity.  I will assume all financial responsibility for all cost that may exceed the amount stated in the insurance policy carried by the Upward Bound Program.

 

I HEREBY AFFIRM THAT ALL FINANCIAL AND EDUCATIONAL INFORMATION LISTED IN THIS APPLICATION IS TRUE AND CORRECT.  I UNDERSTAND THAT THIS INFORMATION IS BEING GIVEN IN CONNECTION WITH THE RECEIPT OF FEDERAL FUNDS, THAT INSTITUTION OFFICIALS MAY VERIFY INFORMATION AND THAT DELIBERATE MISREPRESENTATION MAY SUBJECT ME TO PROSECUTION UNDER APPLICABLE STATE AND FEDERAL STATUTES.

CERTICIFATION

I certify that all of the information provided on this application and in the Family Income Statement section of the application is true and complete to the best of my knowledge.  I understand that Fort Valley State University Upward Bound may ask for proof of any information provided on this application, and I agree to provide the necessary documents.  I understand that if I refuse to provide proof of any information given, the applicant may be denied acceptance into the Upward Bound Program.  Furthermore, I agree that, if chosen to participate in the Fort Valley State University Upward Bound Program, the student will discontinue participation in any other Federally-funded academic program (i.e. GEAR or Talent Search) to avoid the duplication of services.

Assumption of the Risk and Waiver of Liability Relating to Coronavirus/COVID-19

The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID-19 is extremely contagious and is believed to spread mainly from person-to-person contact. As a result, federal, state, and local governments and federal and state health agencies recommend social distancing and have, in many locations, prohibited the congregation of groups of people.

In accordance with the most recent protocols and guidance issued by the World Health Organization, the Center for Disease Controls, the Georgia Department of Public Health and executive orders issued by the Governor of the State of Georgia, Fort Valley State University Upward Bound Program has put in place preventative measures to help reduce the spread of COVID-19; however, we cannot guarantee that you, your child(ren)  and/or your family will not be exposed to or contract COVID-19.

In consideration for allowing my child(ren) to participate in the Fort Valley State University Upward Bound program, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that my child(ren), family and I may be exposed to or contract COVID-19 by attending Upward Bound's on-site or off-site activities, classes, and other events. I understand that the risk of becoming exposed to or infected by COVID-19 at Fort Valley State University's- Upward Bound Program may result from the actions or omissions of myself and others, including, but not limited to, Upward Bound's employees, volunteers, and program participants and their families.

I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to my child(ren) , family and myself including, but not limited to, bodily injury, disability, death, illness, medical treatment or loss of any kind, that may arise from or in connection with my child(ren)’s attendance at Fort Valley State University or participation in Upward Bound's on-site or off-site activities, classes, and other events.

On my behalf, and on behalf of my children, I hereby release, covenant not to sue, discharge, and hold harmless Fort Valley State University, the University System of Georgia, the Georgia Board of Regents, the Upward Bound Program, including each entity’s directors, employees, agents, and representatives, of and from the claims, including all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating thereto. I understand and agree that this release includes any claims based on the actions, omissions, or negligence of Fort Valley State University's- Upward Bound Program, its governing board, directors, employees, agents, and representatives, whether a COVID-19 infection occurs before, during, or after participation in the Upward Bound Program's on-site or off-site activities, classes, and other events.

Further, I agree, represent and warrant that:

 

(1) My child(ren) is not experiencing any symptoms of illness such as cough, shortness of breath or difficulty breathing, fever, chills, repeated shaking with chills, muscle pain, headache, sore throat, or new loss of taste or smell;

(2) My child(ren) has not traveled internationally within the last 14 days;

(3) I do not believe my child(ren) has been exposed to someone with a suspected and/or confirmed case of the Coronavirus/COVID-19;

(4) My child(ren) has not been diagnosed with Coronavirus/Covid-19;

(5) My child(ren) will not participate in the Upward Bound program nor enter an Upward Bound class, activity or associated facility within 14 days of:

(a) traveling to a highly impacted COVID 19 area designated with a travel advisory of 3 or higher; 

(b) coming in contact with any person returning from highly impacted areas with a travel advisory of 3 or higher; or

(c) exposure to any person who has a suspected or confirmed case of COVID-19; o

(6) If my child(ren) experiences any symptoms of illness such as cough, shortness of breath or difficulty breathing, fever, chills, repeated shaking with chills, muscle pain, headache, sore throat, or new loss of taste or smell, my child(ren) will discontinue participation in the Upward Bound program until symptoms have subsided for 14 days. Further, if my child is diagnosed with COVID 19, I will notify the Upward Bound program of said diagnosis.  

 

I HAVE FULLY READ AND VOLUNTARILY SIGN THIS ASSUMPTION OF RISK, RELEASE AND WAIVER OF LIABILITY, AND INDEMNITY AGREEMENT AND FURTHER AGREE THAT NO ORAL REPRESENTATIONS, STATEMENTS OR INDUCEMENT APART FROM THE FOREGOING WRITTEN AGREEMENT HAVE BEEN MADE. I AM AWARE THAT BY AGREEING TO THIS AGREEMENT I AM GIVING UP LEGAL RIGHTS INCLUDING THE RIGHT TO RECOVER DAMAGES FROM FORT VALLEY STATE UNIVERSITY, UPWARD BOUND AND THEIR AFFILIATES IN CASE OF INJURY, ILLNESS, DEATH OR PROPERTY LOSS OR DAMAGE INCLUDING THOSE INJURIES IN CONNECTION WITH COVID-19. I UNDERSTAND THAT THIS DOCUMENT IS A PROMISE NOT TO SUE AND A RELEASE OF AND INDEMNIFICATION FOR ALL CLAIMS. I ALSO UNDERSTAND THAT THIS AGREEMENT IS MADE ON BEHALF OF MY MINOR CHILD(REN) AND/OR LEGAL WARDS AND I REPRESENT AND WARRANT THAT I HAVE FULL AUTHORITY TO SIGN THIS AGREEMENT ON BEHALF OF SUCH MINOR(S).