University Of Southern Maine-SB-UB-Application Form
Language
  • English (US)
  • Arabic‬‎

  • TRIO Upward Bound at USM
    Application

    • Student Information 

    • The following questions will help TRIO Upward Bound at USM learn more about you and your interest in the program. You must complete the required fields and click SUBMIT at the end of the form in order for us to receive your application.

    • Gender*

    • Pronouns*

    • Would you like us to share your contact information with the University of Southern Maine?
    • School*

    • Current Grade*
    •  - -
    • Student's Citizenship/Residency*

    • Student's Ethnic & Racial Identification

    • Does the student identify as Hispanic/Latino/a/x? *
    • With which race(s) does the student most closely identify?*
    • Is the student currently enrolled in an English for Speakers of Other Languages program?*

    • NOTE TO APPLICANTS

      Upward Bound appreciates completed applications by the due date.  We understand that gathering all the information requested may be difficult for some students.  Therefore, Upward Bound will review all applications regardless of their level of completion.  However, due to the small number of openings available each year, not all interested and eligible students will be selected to be interviewed or to participate.

      If you have questions about how to complete this form or your unique situation, including language interpretation or translation of TRIO Upward Bound at USM information, please contact our office at 1-800-800-4876 ext. 5203.

    • Eligibility 

    • Students who participate in Upward Bound at USM are required to meet at least one of the following federal eligibility criteria. These criteria are:

      1. FIRST GENERATION = The biological/adoptive parent(s) with whom the student lives have not completed a bachelor’s degree (4 yr. college) AND/OR
      2. FINANCIAL = Last year’s taxable income is under the limit set for the size of their family unit
      3. ACADEMIC READINESS = Readiness as determined by previous courses, grades, and test scores.

    • Student Information

    • Are you a ward of the state?
    • Are you an emancipated minor?

    • Parent/Guardian Information (for parent/guardian(s) with whom the student lives)

    • Relationship to student*

    • Highest level completed in school*

    • Is there a second parent in the home?*
    • Relationship to student*

    • Highest level completed in school*

    • Additional Information

    • Is either parent/guardian a veteran or currently serving the U.S. Military?
    • Does the student have a parent who resides outside of the home?

    • Family Size & Taxable Income

      Please provide the information below so we can determine if you meet the income eligibility guidelines set by the U.S. Department of Education. If you are a ward of the state or an independent student (emancipated minor) please contact our office.

      Students are financially eligible if your family’s taxable income is not more than the amount listed in the chart.

      To determine this, please tell us the size of your family unit.
      SIZE OF FAMILY UNIT is defined as the total number of persons in your family who are related to you by blood, marriage, or adoption and are dependent on the head of the household for support.
      A step-parent or step-child is considered related by marriage.

      TRIO Programs Income Levels

      Size of Family Unit Last year's taxable income
      1 $23,940
      2 $32,460
      3 $40,980
      4 $49,500
      5 $58,020
      6 $66,540
      7 $75,060
      8 $83,580
      Each Additional Family Member $8,520
    • Did your parents file a federal tax return last year?*

    • Free and Reduced Price Lunch

    • Last school year, the student was eligible for*
    • Currently, the student is eligible for*
    • Statement of Consent 

    • I/We the undersigned, am/are the parent/legal guardian(s) of {main_name}, who is applying to participate in the Upward Bound at USM Program. I/We have read and understand the information provided concerning the program and have discussed the purpose of the program with my/our child. I/We are willing to let them apply for enrollment and agree to their participation in all activities (academic and recreational) deemed suitable by the staff.

      I/We attest that all the information reported on Upward Bound at USM’s application, including CITIZENSHIP/RESIDENCY, FIRST GENERATION, and FINANCIAL ELIGIBILITY, is to the best of my/our knowledge and belief, true, correct and complete.

      Release of School Information:
      I/We the undersigned, the parent(s) or legal guardians of {main_name}, grant permission to Upward Bound at USM to access to all school records including academic transcripts, standardized test scores, special education records, health information, eligibility for free and reduced price school meals, and electronic databases such as Infinite Campus and Naviance. In addition, I/We grant permission for the school, appropriate community agencies, and Upward Bound to share information which will contribute to my/our child’s success.

    • Clear
    •  - -
    • Clear
    •  - -

    • I hereby attest to the fact that all of the information in this application is true and accurate.

    • Clear
    •  - -
    • Questionnaire 

    • Student Questionnaire

      The following questions are optional. Please feel free to write as much or as little as you would like. Any answers you provide will help us get to know you and your family better.

    • 1. What are your goals for continuing your education after high school?

    • Parent/Guardian Questionnaire

    • The University of Southern Maine is an EEO/AA employer, and does not discriminate on the grounds of race, color, religion, sex, sexual orientation, transgender status, gender expression, national origin, citizenship status, age, disability, genetic information or veteran’s status in employment, education, and all other programs and activities. The following person has been designated to handle inquiries regarding non-discrimination policies: Director of Equal Opportunity, 101 North Stevens Hall, University of Maine, Orono, ME  04469-5754, 207.581.1226, TTY 711 (Maine Relay System).

       

      TRIO Upward Bound USM, 7 College Avenue, Gorham, ME 04038 (207) 780-5203 triousm@maine.edu

      TRIO Upward Bound at USM is 100% federally funded at $655,173 annually.

    • Submit 
    • Should be Empty: