SECTION 1: STUDENT INFORMATION

This page to be completed by the STUDENT.

The following information is required by the federal government but has no bearing on your selection for the program.

SECTION 2: PARENT(S)/GUARDIAN(S) INFORMATION

This section is to be completed by the adult who is LEGALLY responsible for the applicant. Information regarding this applicant’s household income is required by the U.S. Department of Education to determine eligibility for participation in the Horizons‐Upward Bound Program. Information requested is kept confidential.

PRIMARY PARENT(S)/GUARDIAN CONTACT

SECONDARY PARENT(S)/GUARDIAN(S) CONTACT (if applicable)

FINANCIAL INFORMATION

ADDITIONAL CONSIDERATIONS

PARENT/GUARDIAN AGREEMENT
I fully support my child’s application for admission into the Cranbrook Horizons‐Upward Bound Program and will attend an interview with my child during New Student Applicant Day.

I verify that all the information ‐ including all financial information reported is true and complete to the best of my knowledge. I understand that falsification of any part of this application may result in my child’s denial or cancellation to the program.

Should my child be chosen to become a part of Horizons‐Upward Bound, I give HUB permission to photograph my student and give consent to the use of those photos for program promotion.

If my child is accepted, I agree to support his/her participation in both HUB’s Summer Component and Academic Year.

I understand that my cooperation with the Horizons‐Upward Bound staff, including participation in Parent Meetings/Workshops is essential to my son/daughter’s admission and continuation in the program.

I will monitor my student’s activities/behavior and will model appropriate behavior when in the presence of students.

I understand that my electronic signature is legally binding and that my electronic signature may not be invalidated solely on the basis that the signature was electronically obtained.

SECTION 3: STUDENT RECORDS RELEASE FORM

Horizons-Upward Bound
PO Box 801
Bloomfield Hills, MI 48303-0801
Office: 248.645.3593 | Fax: 248.645.3081
huboffice@cranbrook.edu

I acknowledge that the purpose of the Cranbrook Horizons‐Upward Bound program is to prepare me/my child to successfully graduate from high school and a four‐year post‐secondary institution of higher education. As a federally‐funded program, Upward Bound must abide by the U.S. Department of Education’s policies and regulations in regards to tracking current and former Upward Bound students [Authorization: U.S. Department of Education: 34 DFR Part 645.32 (b) (4) and (b) (5)]. As such, I understand Horizons‐Upward Bound’s obligation in obtaining academic documentation from my current or previous high school(s) and six years following the end of my high school graduation and enrollment into a four‐year post‐secondary institution.

I hereby authorize all high‐school and post‐secondary documentation (transcripts/ grades, testing, attendance and citizenship information) to be released to Cranbrook Horizons‐Upward Bound.

I understand that my electronic signature is legally binding and that my electronic signature may not be invalidated solely on the basis that the signature was electronically obtained.

SAVE THE DATE

NEW STUDENT/PARENT APPLICANT DAY

APRIL 24, 2021

1:00 PM – 5:00 PM
HORIZONS-UPWARD BOUND
Cranbrook Schools

Students who submit a complete application will be mailed an invitation letter with details to attend Cranbrook Horizons-Upward Bound’s New Applicant Student/Parent Day in early April.

To be considered for the Horizon-Upward Bound Program the student must attend a Detroit Public School. Both student and parent/guardian must attend April 24!

Cranbrook Horizons-Upward Bound is funded by a US Department of Education Grant and private sources. 

THERE IS NO MAKE-UP DAY 

Cranbrook Horizons-Upward Bound
39221 Woodward Ave.
PO Box 801
Bloomfield Hills, MI 48303
Office: 248.645.3593 | Fax: 248.645.3081
huboffice@cranbrook.edu

CONTACT

 Ms. Brenda Gatlin

Office: 248.645.3184

Cell: 313.715.4107