Dear Applicant:

On behalf of the students and staff of Upward Bound Programs and Chicago State University, we want to thank you for your interest in our program. We are very proud of the Upward Bound Program and invite you to apply. By completing this application, you are taking a vital step that will put YOU in control of your future. Each year there are approximately thirty openings, therefore, it is very important that you do your very best when you complete this application. Read the instructions below to assist you. If you have any questions, please feel free to call the Upward Bound office at 773.995.2566.

Best regards,
The Upward Bound Staff

STUDENT ADMISSION GUIDE
(Please read then Proceed)

1. FIRST, please read the Upward Bound II Information Flyer. Make certain you and your parent(s)/guardian understand what the program is and that you really want to become a part of Upward Bound.
2. THEN, please READ the ENTIRE application BEFORE answering any questions.
3. Answer each question THOROUGHLY and CAREFULLY. DO YOUR BEST!
4. Make certain your parent/guardian complete and sign the Family Financial Statement on pages 4.
5. Last 4 of social security number, last quarter grades and income verification (medical card or parents 1040) MUST BE attached to the application.
6. As soon as you and your parent/guardian have completed the application, please email your application to upwardbound2csu@gmail.com. Your application is incomplete without document listed on #5.
7. When all of your forms are received by the Upward Bound office we will contact you within 5 business days with an admissions/denial decision.

PERSONAL DATA

If you are in Elementary School, please complete this section: 

If you are in High School, please complete this section:

FAMILY ELIGIBILITY STATEMENT: To be completed by the parent(s) or legal guardian of the student applicant Upward Bound II is designed for students who are potential first generation college students and/or from low-income families. The information provided on this form is necessary to make certain that the student is eligible for the program. Of course, this information will be held in strictest confidence. If you have any questions, please call the Upward Bound II office.

PARENT(S)/GUARDIAN PERSONAL DATA

 

(Mother/Female Guardian)

If YES, complete this section below

(Father/Male Guardian)

If YES, please complete this section below:

PARENT/GUARDIAN DECLARATION
I/We declare that the college information provided above is true and correct.

The U.S. Department of Education requires that we document the family income for each student who is admitted to the program. You must attach a copy of your MOST RECENT tax return (Form 1040 or 1040-A) with this form. If you did not file a tax return or one is not available, then please submit a copy of other documentation of income, such as:

1. Your most recent Public Aid Medical Card and Illinois LINK card (front and back).
2. Check stubs from your most recent Social Security check, SSI check, pension check, etc.

If your family receives Public Assistance, please provide the following:

SIGNATURE:
I certify that all of the above information is true and correct and that all income is reported. I understand that this information is being given to determine the student applicant’s eligibility for Upward Bound II; that Upward Bound II staff may verify the information on the application; and that deliberate misrepresentation of the information may cause the applicant to be denied admission to Upward Bound II at Chicago State University.