Directions- Please answer all questions marked with *

Please check all the following UB services and activities that you need or are interested in receiving:

PERSONAL ESSAY 

The personal essay is an important part of the selection process.  In a 250 or more word essay (or in a two minute video of yourself) answer and discuss ONE of the following questions:

1) What is your purpose in applying to the Upward Bound Program? What do you believe you will gain from the experience, and what contributions can you make to the program?

2) What events or persons in your background have influenced you in your educational and career goals?

3) Discuss a personal, local, national, or international issue that concerns you.

4) What are your dreams for the future? 

***Teacher/Counselor Recommendation Forms***
Please email the below Recommendation Form Link to at least two (2) teachers or a teacher and a counselor at your high school. Remind your teacher(s)/counselor(s) to submit their forms within 5 days of your application submission.

https://botform.compansol.com/202794874736066

***Please complete parts IV, V, and VI of the application with your parent(s)/guardian(s).***

The US Department of Education requires that TRiO Upward Bound collect this data in order to determine student eligibility. Failure to provide the necessary supporting documents will prohibit your child from being considered for acceptance. The information you provide to Upward Bound is confidential and is protected by the Privacy Act.

2) First Generation Status: (Parent/Guardian Education Level)

3) Low-Income Status:

In accordance with the TRIO Upward Bound eligibility requirements set forth by the U.S. Department of Education, I hereby certify and attest under penalty of perjury that the information I have provided on this application is true and correct to the best of my knowledge. I authorize Pima Community College- Desert Vista Campus Upward Bound Program access to my student’s academic and personal information through the school or district database and/or to receive copies of transcripts, test scores, and any other information that may be necessary for participation in the program. I further authorize the staff of Pima Community College- Desert Vista Campus Upward Bound Program access to my student’s college enrollment, retention, and completion information, as well as financial aid information from colleges and the federal government. I further certify that I am aware that the provision of any false, fictitious, or fraudulent information or the omission of any material fact may subject me to criminal, civil or administrative penalties for fraud, false statements, false claims, or other violations. (U.S. Code Title 18, Section 1001; Title 20, Section 1097; and Title 31, Sections 3729-20 and 3801-3812). 

The following consent shall be valid for the entire duration of my son/daughter’s participation in Upward Bound and until completion of a bachelor’s degree, or for 6 years following graduation from high school. I hereby grant permission for my son/daughter to participate in the Pima Community College – Desert Vista Campus Upward Bound Program year round programing. I also give my consent for the following:

•  For the high school where my son/daughter is enrolled to make available to the Upward Bound Program staff academic records (class schedules, test scores, transcripts, and attendance) 

• Communication to obtain documentation verifying an applicant’s U.S. citizenship, or national permanent resident status, or of his or her intent to become a permanent resident.