Students may apply for enrollment if they attend Mifflin, East, Northland, Linden-McKinley, or Independence High School, and meet the following criteria:

• US citizen/permanent resident
• Rising 9th grader (summer after 8th grade), or current 9th and 10th grader
• Minimum cumulative GPA of 2.5
• Potential first-generation college student (neither parent could have obtained a Bachelor’s degree or higher)
• Belong to an income-eligible household
• Interested in attending and graduating from college
• Wants to be an active participant in the program
• Have transportation to and from UB activities

Dear Student and Parent/Guardian:

Applications for the Upward Bound (UB) program are accepted on a rolling basis. We invite you today to apply for an opportunity to participate.

UB is a federally-funded, pre-college program for high school students enrolled in grades 9-12. The program is designed to generate skills and motivation necessary to complete high school and to enter and succeed in a program of postsecondary education which can include a community college, 4-year university, or vocational/trade school.

Some of the benefits of UB include: academic enrichment sessions, tutoring, stipend payment for attendance, cultural/social activities, leadership development and career information workshops.

Admission to UB is not automatic; students must complete the application and selection process. One of the most important aspects of our process is an interview with you and at least one parent or guardian. An interview is required for all applicants. The UB staff is flexible and would like to plan the interview time that is most convenient. Interviews usually last about one hour and are held virtually via Microsoft Teams or by phone. Please indicate below the best time for an interview:

Click here to schedule your interview if you attend, or will be attending, Linden-McKinley STEM Academy or Independence High School – Sabrina Mosely, UB Advisor

Click here to schedule your interview if you attend, or will be attending, East High School – Jameka Wiggins, UB Advisor

Click here to schedule your interview if you attend, or will be attending, Northland High School – Jarrett Murphy, UB Advisor

Click here to schedule your interview if you attend, or will be attending, Mifflin High School – Lori Billenstein, UB Manager

Your interview date and time will be confirmed by a UB team member after your application is submitted.  A parent or guardian must accompany applicants during the interview.

**Make sure that all requested information is complete and that all signature fields are signed

**If the student applying for enrollment is currently under foster care, please have his/her case worker complete and sign this application

Upward Bound is funded 100% by the Department of Education, in the amount of $346,319 annually. This funding serves 70 students.

This information is strictly confidential. Financial and other personal information you give to the Columbus State Community College Upward Bound program is protected by the General Education Provision Act (Privacy Rights of Parents and Students/Buckley Amendment). Upward Bound and the U.S. Department of Education may not release any information without your written consent.

I certify that the information in this application is true and complete to the best of my knowledge.

To be completed by a parent or guardian

The following determines whether or not the student meets federal income guidelines:

The personal information that you give to the Upward Bound (UB) Program is required by the U.S. Department of Education.  No one may see the information unless they work with or for the UB program or the U.S. Depratment of Education.  The General Edducation Provision Act (Private Rights of Parents and Students) or more generally known as the Buckley Amendment, offers parents the option of sending their financial ifnromation under separate cover (i.e. this page may be detached and sent separately form the student's application ) and such information shall be confidential and not available to the student.  This information is necessary to determine if your child is eligible to participate in the UB program.  The student is not elgible for UB services unless this information is provided.

Please indicate the level of your Total Family TAXABLE Income for 2023.  Please contact the UB Office at (614) 287-5875 if you have any questions about this.

MOTHER

FATHER

I certify that the information in this application is true and complete to the best of my knowledge.

*To sign: place mouse inside signature box, press down, then drag mouse in motion of signature.

To be completed by student and a parent or guardian

I authorize the Columbus State Community College Upward Bound (UB) program staff members to obtain documents relative to and consistent with my (child’s) education. Such documents include but are not limited to: a copy of school transcript, test scores, and school lunch program eligibility. UB understands that it may generate or otherwise be in possession of confidential education records regarding students, and such records are protected by federal law including, inter alia, the Family Educational Rights and Privacy Act (“FERPA”), 20 U.S.C.A. §1232g, as well as R.C. 3319.321, Ohio’s Confidentiality of Student Information statute (“CSI”). UB and its employees expressly agree that they may not share or disclose education records except in fulfillment of and in performance of the obligations of this Release for Academic Information or as may be permitted or required by FERPA and CSI. I authorize UB to obtain information related to my/the student’s application for college admission and acceptance status, financial aid application (FAFSA), and award letter at any and all colleges and universities, as well as current enrollment status and/or number of credits enrolled. I authorize UB to release or to obtain information from any agency or program providing supplemental educational services. I give permission for the student to participate in UB activities (including in-school advising on school premises and those that involve travel), tutoring. I authorize UB to obtain the above information from my/student’s entry into the program throughout their post-secondary education for completion verification regarding its use only for UB purposes and non re-disclosure.

*To sign: place mouse inside signature box, press down, then drag mouse in motion of signature.

*To sign: place mouse inside signature box, press down, then drag mouse in motion of signature.

Columbus State Community College Upward Bound
(U.S. Department of Education TRIO Programs)
Columbus State Community College
Attn: Upward Bound Program
550 East Spring Street, Franklin Hall 223
Columbus, OH 43215
FAX: 614.287.6296
PHONE: 614.287.2494

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