• Northern Oklahoma College Enid

    Upward Bound Academy Application
    • Student Information 
    • Birth Date*
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    • Gender*

    • Ethnic Background*

    • Are you a citizen of the United States?
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    • My child _______ have a current IEP on file at his/her school
    • How did you hear about us? (Please check all that apply)

    • Family Information 
    • Whom does the student live with?

    • Does either parent have a 4-year college degree?*
    • Is anyone in your family receiving services from Upward Bound?
    • Is anyone in your family receiving services from a Gear Up program?
    • Financial Information 
    • Does anyone in your household receive the following? (Please check all that apply)*

    • Statement Of Confidentiality 

    • The information you provide in this application is confidential according to the Family Rights and Privacy Act. The U.S. Department of Education has the authority to gather the information requested in this application (20 USC 1231a).  The only persons authorized to examine the contents of this application are the student, his/her parents, employees at the school attended, and authorized Upward Bound staff.

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    • *In order to sign: position mouse over the designated signature area, hold the mouse button down, then proceed to drag in the form of your signature.

    • Date Signed
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