College Of The Redwoods-UB-Application Form

TRiO Upward Bound Program Application
A Federal TRiO Program

Thank you for your interest in the Upward Bound Program. Upward Bound is a year-round program designed to serve high-potential students who are interested in attending college after graduating from high school.

You are encouraged to apply if:
1. You are from an income eligible family, and/or
2. Neither of your parents/guardians possess a bachelor's degree (also known as a "four year degree").
3. You are or will be attending Castle Rock Charter School, Del Norte High School, Eureka High School, Fortuna High School, East High or Pacific View Charter School.
4. You are currently in 8th-12th grade (fall semester of 12th grade)
5. Your GPA is 2.0 or greater. If not, you may appeal to the Director by showing improvement in a recent grade report.
All costs for this program are paid by the U.S. Department of Education. There are no charges of any kind to participating students or their families.

During the academic year, Upward Bound participants are eligible to receive:
- Assistance in preparing college admissions forms
- Standardized test preparation
- Assistance in preparing financial aid forms
- College and career advising
- Tutorial services
- Fee waivers for SAT/ACT tests and college applications
During the summer session, Upward Bound participants are eligible to:
- Attend an academic residential program at College of the Redwoods Eureka campus
- Participate in challenging Upward Bound/CR classes for high school/college credit
- Receive help in formulating an educational plan
- Learn study skills and time management techniques
- Work with college student mentors
- Enjoy academic enrichment activities, community events, and field trips
If you want help making college part of your future and you are interested in our program we invite you to apply. When you submit this online application, it will be forwarded to your campus Upward Bound Academic Advisor for review.

If you need to continue your application at a later time, please click the "Save" button at the bottom of the form. Click “Skip Create an Account” at the bottom of the pop-up. Then, you can either click the "Get sharable link" to have a unique link to your form copied to your clipboard, or you can enter an email address and click "Send link" to have an email sent containing the unique link to your form.

In order for us to process your application, you must turn in all of the following, completed and signed:
- The Student Information Page
- The Student Personal Response and Needs Assessment
- The Student Contract
- The Counselor/Teacher Recommendation Form
- The Parent/Guardian Information page
- Income Verification page
- The Release of School Records Form
Questions? From Humboldt County: (707) 476-4277, or toll free (800) 641-0400 ext. 4277 From Del Norte County: (707) 465-2341, or toll free (800) 641-0400 ext. 2341 We have voicemail, so you can call and leave us a message anytime.

As provided by law, College of the Redwoods' Upward Boud Program does not discriminate on the basis of ethnicity, religion, gender, color or disability in any of its activities.

Del Norte County
883 W. Washington Blvd.
Crescent City, CA 95531
707-465-2341 or (800) 541-0400 ext. 2341

Humboldt County
7351 Tompkins Hill Rd.
Eureka, CA 95501-9300
707-476-4277 or (800) 641-0400 ext. 4277

www.redwoods.edu/upwardbound
www.facebook.com/crupwardbound
www.instagram.com/redwoodsupwardbound/

Student Personal Response
Name of Applicant*

First NameLast Name
Date*

MonthDayYear
mm-dd-yyyy
An important part of the selection process is the application essay. Give specific examples and tell us as much about yourself as possible. Use your authentic voice (be real) and understand that we want to know about YOU. Tell us in writing: What are your greatest concerns and challenges or barriers to being a successful high school student? Do you have a history of low grades? What subjects do you feel are most challenging? Do you have trouble talking to your teachers regarding assignments or just in general?. (You may attach a document containing your essay instead of writing in the box.) *
Attach documents here

Browse Files

Cancelof
By signing here you confirm that this essay was written by you alone.*

Clear

Student Needs Assessment

Please review each statement below and indicate either yes, I need assistance in this area, or no, I do not need assistance in this area.

	Yes	No
Being more organized
Managing time better
Improving study skills
Reducing test anxiety
Understanding test scores in relation to academic career planning
Developing course schedule
Understanding career options
Planning options after high school
The college application process
Understanding learning styles
Financial aid and scholarship information
Relationships with teachers
Understanding graduation requirements
Selecting a career paths

Student Contract
The Upward Bound Program at the College of the Redwoods agrees to:
- Help you formulate a career plan.
- Provide personalized college prep information.
- Assist you with the development of an educational plan.
- Provide you with information on choosing a college that meets your needs.
- Assist you in preparing college admissions forms.
- Assist you in preparing financial aid forms.
- Offer a summer residential program with top quality instructors and a variety of classes.
I agree to:
- Pursue recommended college preparatory classes at my high school that include:
  1. History/Social Science - 2 years
  2. English - 4 years
  3. Mathematics - 3 years (Algebra, Geometry, and Algebra 2 or their equivalents; 4 years recommended
  4. Laboratory Science - 2 years; 3 years recommended
  5. Language other than English - 2 years; 3 years recommended
  6. Visual or Performing Art - 1 year
  7. College Preparatory Electives - 1 year (Successful completion of this sequence of classes will meet the minimum UC/CSU high school preparatory course requirements.)
- Maintain the highest standards of personal conduct.
- Complete assignments and courses.
- Seek support services when needed.
- Participate in the academic year and summer residential activities.
- Attend at least one Upward Bound summer program session.
- Observe the Upward Bound program rules and regulations.
- Graduate from high school and enroll in college or other postsecondary educational programs.
I understand that:
- The Upward Bound Program requires that I maintain at least a 2.5 GPA as a freshman; at least a 2.6 GPA as a sophomore; and at least a 2.75 GPA as a junior and senior.
- If my grades fall below this minimum or if I receive a D or F in any class that I will be required to work together with the Upward Bound staff to formulate an academic improvement plan. This plan will outline the steps needed to improve my grades. I also understand that if my grades do not improve by the next grading period I may be dismissed from the Upward Bound Program.
- Inappropriate conduct at school or during Upward Bound activities may also result in dismissal from the Upward Bound Program.
Student Signature*

Clear
Date*

MonthDayYear
mm-dd-yyyy

Counselor/Teacher Recommendation Form
Please provide the name and email address of the teacher or counselor who you have asked to fill out the Upward Bound Teacher/Counselor Recommendation Form. They will receive an email with a link where they can fill out your recommendation form and submit it to Upward Bound.
Counselor/Teacher Name*

First NameLast Name
Counselor/Teacher Email*
example@example.com

Income Verification
Dear Parents and Guardians:

Thank you for taking the time to help your student apply for this great opportunity! in order to determine if your student is eligible for services, we need to gather information from you regarding your income and educational history. Please fill out the boxes below for verification of your income eligibility according to the recent Federal TRIO Programs Annual Low Income Levels.

https://www2.ed.gov/about/offices/list/ope/trio/incomelevels.html

Note: The personal information, including financial status and educational levels, given to the Upward Bound Program is used for reporting purposes with the United States Department of Education (USDE). No one may access, view, or utilize the information unless they work with or for Upward Bound at College of the Redwoods, unless they are given specific or legal authorization to said information. This information is required to determine if your child meets federal eligibility guidelines established by regulation of the USDE. All information is protected under the Family Educational Rights and Privacy Act (FERPA, 20 USC 1231a).

If you are in foster care, you are considered independent and you only report your own income if you have any. Your foster parent should include verification that you are in foster care in the next section, usually in the form of a letter from the social worker.
Parent/Guardian Name*

First NameLast Name
Student Name*

First NameLast Name
Annual Taxable Income for the Last Calendar Year (If you filed a tax return last year, the amount given in box 11b is your annual taxable income.)*
Taxable Income includes:
- Wages
- Alimony Received
- Unemployment benefits
- Freelance income
Taxable Income does not include:
- Child support payments
- Supplemental Security Income
- Veterans Benefits
- Welfare Benefits
Number of People in Household (Include yourself) *
Parent/Guardian Signature*

Clear
Date*

MonthDayYear
mm-dd-yyyy
Please call our office with any questions you have at (707) 476-4277 or (800) 641-0400 ext. 4277.

Release of School Records
Name of Applicant*

First NameLast Name
Release of School Records to the College of the Redwoods Upward Bound Program

Parent/Guardian: As the parent/legal guardian of this student, I give my permission for them to participate in the Upward Bound program. I hereby consent for Upward Bound to access my student's school records and to collaborate with school personnel on their behalf. In addition, my signature allows Upward Bound to contact me and or access information from college, state, or national databases to track my student's postsecondary progress.
Parent/Guardian Name*

First NameLast Name
Parent/Guardian Signature*

Clear
Date*

MonthDayYear
mm-dd-yyyy
Student: I hereby consent for Upward Bound to access my school records and to collaborate with school personnel on my behalf. In addition, my signature allows Upward Bound to contact me and or access information from college, state, or national databases to track my postsecondary progress.
Student Name*

First NameLast Name
Student Signature*

Clear
Date*

MonthDayYear
mm-dd-yyyy