College of Charleston-UB-Application Form

College of Charleston
Upward Bound

Dear Upward Bound Applicant and Parent(s)/ Guardian,

Thank you for your interest in our program and wanting your child to become a part of a program that will empower and educate them in all areas to prepare them for their postsecondary education experience. All application materials must be filled-in completely.
Incomplete applications will delay the acceptance process. After the application has been reviewed, students are requested to participate in a scheduled individual interview, either at the Upward Bound office (parent must be in attendance) or virtually to accommodate the family.

To be eligible for the College of Charleston Upward Bound Pre-College Program, a student must meet U.S. Department of Education’s Socio-economic income level guidelines and/or they must be a potential first generation college student (neither parents has a bachelor’s degree). Also, the student must be scheduled to attend one of the target schools listed below:

R.B. Stall High School	West Ashley High School
Burke High School	St. Johns High School
North Charleston High School

All information provided to the program is confidential. See program brochure for additional information. Please feel free to contact our office if you have any questions or concerns:

Mr. Lessane (Director, Upward Bound and Pre-College Programs)
953.6555 lessaneta@cofc.edu
Mrs. Sanders-Hernandez (Academic Counselor)
953-1860 sandershernandezs@cofc.edu

Students are prohibited by law from attending any Upward Bound sessions until all necessary information has been submitted and received by Upward Bound staff.

Mailing address:
Upward Bound - College of Charleston
25 St. Philip Street, Room 121-124
Charleston, SC 29424
http://upwardbound.cofc.edu/index.php
FAX:843-953-4902

Family Checklist
Name of Student*

First NameLast Name
School*
Enclosed Forms (please check off once every form is completed)

1. Upward Bound Applcation2. Family Application3. Income Verification Form4. Student Essay5. School Realease Form6. Power School Authorization Form
**Teacher and Counselor recommendation forms will be sent to you to email to your teacher and counselor, once the application is completed**

I certify that the information provided in this packet is true and complete to the best of my knowledge.
Parent/Guardian Signature*

Clear
Date*

MonthDayYear
mm-dd-yyyy

III. Income Verification Form
For Purposes of documentation, please provide the information from your most recent Federal Tax Income. If you do not file tax return you will be required to provide another source of income verification before the application can be processed. Please give the correct response that verifies annual income and give the number that lives in your household.
Size of Family Unit*
Yearly Income Total $*
I, (parent/guardian) {parentguardian}, certify the information given above is true and accurate. I understand that if any information if found to be invalid, it could serve as a basis for my child to be dismissed or not considered for the Upward Bound Program.
Parent/Guardian*

First NameLast Name
Parent/Guardian Signature*

Clear
Date*

MonthDayYear
mm-dd-yyyy

IV. Student Essay
What are your educational and career goals and how can Trio Upward Bound help you achieve them? (maximum of 250 words)*

0/250

VII. School Release Form
RELEASE OF SCHOOL RECORDS

I hereby authorize the Charleston County School that my son/daughter attends to release the following information form the records. For the purpose of maintaining records and accountability for all participants in the Upward Bound Program.
Student's Name*

First NameLast Name
- Educational Records (Report Cards, progress reports, standardized test records, etc.)
- Official Transcript
- Student Activities
- Psychological Reports
- Disciplinary/Behavioral Records
- Health Data
The Information will be release to:

College of Charleston
Upward Bound
66 George Street
Charleston, SC 29424
Phone (843)953-5469 Fax (843) 953-4902
Parent/Guardian Name*

First NameLast Name
Parent/Guardian Signature*

Clear
Date*

MonthDayYear
mm-dd-yyyy
Address*

Street Address

Apt #

CityState / Province

Postal / Zip Code
Telephone Number*
(999)999-9999
Email*
example@example.com

PowerSchool Parent Portal Access
PowerSchool Parent Portal Access

PowerSchool Parent Portal is a tool that is integrated into the PowerSchool Student Information System (SIS) that is specifically developed for parents and students.

PowerSchool Parent Portal gives parents and students access to real-time information including attendance, grades and detailed assignment descriptions, school bulletins and even personal messages from the teacher. Everyone stays connected: Students stay on top of assignments, parents are able to participate more fully in their student's progress, and teachers can use their gradebook to make decisions on what information they want to share with parents and students.

The Upward Bound Program is requesting access to the Power School Parent Portal information for your student. This access will allow us the opportunity to monitor grades, class schedules, academic progress, attendance, and other information needed in an effort to enhance our advocacy and intervention as it relates to your child's education. We will ONLY use this information for the purposes of keeping accurate accounts of the student's academic progress, to assign tutoring and/or other academic intervention strategies, and to alert student and parent of the need for intervention at the first indication of academic need. The Upward Bound Program assumes NO responsibility for any changes made to the child's schedule and/or academic record as we serve as advocates and advisors only to both student and parent. By signing this document, you grant us access to your student's Power School information using the credentials you provide in the space below.
Student Name*

First NameLast Name
Parent Name*

First NameLast Name
Username*
Password*
Parent Signature*

Clear
Student Signature*

Clear