Parent/Guardian Information

Complete parent/guardian information for each parent/guardian in your household and any parent/guardian who provides financial support.

Income Information

• If selected, we will attend a parent/student interview. If admitted into BCUB, we will follow all requirements, including attending tutoring and workshops during the academic year and participating in a six-week summer program.
• I attest that the information provided is true and accurate. I understand it will be used to determine the eligibility of my child in a federally funded program and that documentation may be requested.

I authorize TRIO BCUB to:
(a) record my likeness and voice on a video, audio, photographic, digital, electronic and any other device or medium;
(b) Use my name in connection with these recordings; and
(c) Use, reproduce, exhibit or distribute in any medium (including but not limited to, print publications, video tapes, CD-ROM, Internet, social media or any other medium) these recordings for any purpose that BC, and those acting pursuant to its authority, deem appropriate, including promotional or advertising efforts. I release BC and those acting pursuant to its authority from liability for any violation for any personal or proprietary right I may have in connection with such use. I understand that all such recordings, in whatever medium, shall remain the property of BC, and that I will not receive any compensation for the use of such recordings. I have read and fully understand the terms of this release.