Oklahoma State University-Oklahoma City-UB-Application Form

Upward Bound Application
For more information please contact:
Upward Bound
900 N. Portland Ave.
Oklahoma City, OK 73107
Phone (405) 945-8623
Fax (405) 945-8628
osuokc.edu/upwardbound

Upward Bound is a Federally funded TRIO program. TRIO programs are funded under Title IV of the Higher Education Act of 1965 to help students overcome class, social, academic and cultural barriers to higher education.

ELIGIBILITY CRITERIA
ELIGIBILITY CRITERIA
- Attend Western Heights or Putnam City West high schools
- Be in the 8th, 9th, 10th or 11th grade
- Be between the ages of 13 and 19
- Have a desire to go to college
- Be a U.S. citizen, national of the U.S., a permanent resident of the U.S., or in the U.S. for other than a temporary purpose and provide evidence from Immigration and Naturalization Service of intent to become a permanent citizen.
- Be a potential first-generation college student (no parent, guardian or sibling in the immediate household has earned a baccalaureate degree) AND/OR meet the federal income guidelines below.
Federal TRIO Programs 2020 Annual Low Income Levels
Size of Family Family’s Taxable Income is this amount or less

1 $19,140
2 $25,860
3 $32,580
4 $39,300
5 $46,020
6 $52,740
7 $59,460
8 $66,180

For family units with more than 8 members, add $6,720 for each additional family member.

APPLICATION INSTRUCTIONS
APPLICATION INSTRUCTIONS

Complete online application on website or attached forms.
Submit following to Upward Bound office at address on cover page.
1. With the help of your parent(s) complete and submit online or paper Application. Information received in the Upward Bound office is confidential and used for record keeping purposes only.
2. Submit with application or at interview ONE of the following for Income Verification:
  1. Signed copy of parent/guardian’s most recent federal tax return
  2. Verification of current public assistance from a government source (such as AFDC, SNAP, Social Security benefits)
3. Submit or have school send ALL of the following Academic Information:
  1. 8th grade Oklahoma School Testing Program (OSTP) scores in reading and math
  2. Grade report for 8th grade
  3. Recent high school transcript
  4. Copy of Individual Education Plan, if student has one
4. Submit the Student Recommendation Form completed by a teacher, counselor, employer or community member who is not related to the applicant.
5. Submit with application or at interview a copy of student’s Social Security card.
If you are selected for an interview, you will be contacted by Upward Bound to set up an appointment.

If you do not have access to copier, copies of required documents can be made at the Upward Bound office.

VERIFICATION OF INCOME
VERIFICATION OF INCOME

Federal regulations require verification of family income as part of the application process for Upward Bound. Documents may be submitted with application or presented at student interview.
Number of people in household*
Select how you will verify annual income:*

Federal Tax ReturnHousehold NOT required to file a Federal Tax Return
Taxable Income amount listed on Federal Tax Return*
Provide signed copy of most recent year’s Federal Tax Return (pages 1 & 2)*

Browse Files

Cancelof
Total earnings (Gross Income) for the previous tax year*
Sources of income:*

Aid to Families with Dependent Children (AFDC)Supplemental Nutrition Assistance Program (SNAP)Aid from HUDMedicaid BenefitsDisability BenefitsOther
I hereby certify that the information and attached documents provided to support this application are true and correct, and I understand that deliberate misrepresentation of the information may subject me to prosecution under applicable state and federal laws.
Parent/Guardian Name*

First NameLast Name
Signature of Parent/Guardian*

Clear
Date*

MonthDayYear
mm-dd-yyyy
Parent/Guardian Name*

First NameLast Name
Signature of Parent/Guardian*

Clear
Date*

MonthDayYear
mm-dd-yyyy
Student Name*

First NameLast Name
Signature of Student*

Clear
Date*

MonthDayYear
mm-dd-yyyy

RECORDS RELEASE AUTHORIZATION
RECORDS RELEASE AUTHORIZATION
I, __________________________________, authorize the OSU-OKC Upward Bound Program to obtain the school records...*
Guardian’s Full Name
...of ______________________ for use in educational planning. I authorize them permission to secure necessary records, report cards, test scores or student information from student’s middle, high school and career technology records.*
Student’s Full Name
Date*

MonthDayYear
mm-dd-yyyy
Student Signature*

Clear
Guardian Signature*

Clear