Kankakee Community College-UB-Application Form
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  • TRIO Upward Bound Application

    • Student Information 
    • Date of Birth*
       - -
    • Gender*
    • Citizen Status*
    • Do we have your permission to text you?*
    • Ethnic/Racial Background - please check all that apply
    • Do you have an Individualized Education Program (IEP) or Section 504 Plan?*
    • Parent/Guardian Information 
    • Have either of your parents earned a four-year degree?*

    • Household/Financial Information 
    • Total number of people living in your household including yourself*
    • Please check the box that corresponds with the range in which your household’s taxable income falls for the most recent tax year. If you filed taxes, taxable income is reported on the line labeled “Taxable Income” on the 1040 tax return (Line 15 on the current form).*

    • Kankakee Community College's Upward Bound program is fully funded by the U.S. Department of Education.

      By signing this application, you certify that the information submitted is correct. You understand this information is strictly confidential and will be maintained in the Upward Bound office at Kankakee Community College.

    • Clear

    • Kankakee Community College's Upward Bound program is fully funded by
      the U.S. Department of Education.

      By signing this application, you certify that the information submitted is
      correct. You understand this information is strictly confidential and will be
      maintained in the Upward Bound office at Kankakee Community College.

      I acknowledge the income information provided on this form is true and
      correct. I understand that I may be required to submit a signed copy of my
      U.S. tax return to prove income, as required by the Department of
      Education. If I fail to provide this documentation, I understand the applicant
      may not be accepted into the program.

      I authorize my child's high school to release high school transcripts, test
      scores and grade reports.

    • Clear
    • Submit 
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