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  • Middle Georgia Center for Academic Excellence
    Educational Talent Search/Upward Bound
    Division of Family and Children Services (Afterschool Care)
    623 Arlington Place Macon, Georgia

    Phone (478) 745-1675       Fax (478) 745-3359

    Educational Talent Search TRIO is a free program designed to assist, prepare and encourage middle and high school students with academic potential in the pursuit of studying beyond the high school level with the exploration of college and career opportunities.  The M.G.C.A.E. Inc. along with the Division of Family and Children Services are partnering to provide valuable and exciting out-of-school programs for youth in GA.  The information provided on this form will help ensure that eligible youth are benefiting from the partnership.  Please provide all information in all sections of this application for application to be complete and processed.  The parent/guardian’s signature verifies that income, benefits and all other information reported on this application is true and accurate.

    • Student Information 
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    • Parent/Guardian Information 


    • Financial Information 
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    • Agreements and Medical Information 
    • As the parent/guardian of (child’s name), I grant the M.G.C.A.E. and Division of Family and Children Services permission to access and obtain school records, transcripts, grade reports, test results and any financial information and to speak with teachers, counselors and other school administrators in order to obtain and exchange information as part of the services provided by the M.G.C.A.E. program. 

      I authorize and permit my child to participate in field trips, activities and events sponsored and conducted by the M.G.C.A.E. and Division of Family and Children Services program.  I understand that M.G.C.A.E. may be providing transportation and that my child will be leaving his/her school campus or M.G.C.A.E. grounds with its staff.  I agree that M.G.C.A.E., Division of Family Services and anyone associated with M.G.C.A.E. and Division of Family and Children Services will NOT be held liable for any loss, injury, or death related to any field trip, activity or events in which my child is authorized to participate.  Furthermore, I agree to hold M.G.C.A.E, its Board of Directors, officers, staff, volunteers and Division of Family and Children Services harmless of any claims occasioned in any of the situation to which I have agreed that M.G.C.A.E. shall not be liable. 

      I grant M.G.C.A.E. and Division of Family and Children Services permission and the right to take photographs of my child in connection with M.G.C.A.E. and Division of Family and Children Services, and I authorize its assigns and transferees to copyright, use and publish the same in print or electronically and use such images with or without my child’s name for any lawful purpose such as publicity, illustration, advertising and web content. 

      I grant permission for my child to access network computer services such as the internet, WWW and electronic email associated with M.G.C.A.E. and Division of Family and Children Services. 

      In the event that my child is involved in a medically necessary event, I authorize M.G.C.A.E. and Division of Family and Children Services to make decisions regarding the immediate medical care (hospitalization, administration of medication, physician treatment, medical transport, etc.) if I am not available or unable to authorize verbal permission. 

      Student’s Medical History:  Please list any allergies, medications and any physical or other impairments of which a physician or medical staff should be alerted:

    • My signature declares that the income and all information given on this application is true and accurate.

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