Baltimore City Community College-UBMS-Application Form Logo

  • Baltimore City Community College Upward Bound Math/Science Program

    STUDENT APPLICATION

  • This application must be completed by parent(s)/guardian(s) and student.

    • STUDENT INFORMATION 
    •  - -

    • CITIZENSHIP:

    • PARENT/GUARDIAN/EMERGENY CONTACT INFORMATION 

    • MOTHER/FEMALE GUARDIAN: Income and Occupation

    • FATHER/MALE GUARDIAN: Income and Occupation

    • FIRST GENERATION STATUS Parent(s) Guardian(s) Education

      MOTHER/FEMALE GUARDIAN:

    • FIRST GENERATION STATUS Parent(s) Guardian(s) Education

      FATHER/MALE GUARDIAN:

    • EMERGENCY NOTIFICATION INFORMATION

      Emergency Contact #1 (Other than Guardian(s)

    • EMERGENCY NOTIFICATION INFORMATION

      Emergency Contact #2 (Other than Guardian(s)

    • MEDICAL DISABILITIES OR SPECIAL CARE REQUIRED INFORMATION

    • SCHOOL INFORMATION 
    • FILE ATTACHMENTS 

    • THE FOLLOWING MUST BE SUBMITTED WITH THIS APPLICATION:


      ; Teacher’s Evaluation and Counselor’s Recommendation


      ; Personal Goals Statement

          Describing your educational and life goals, and explain how participating in the BCCC Upward Bound Math/Science Program will help you achieve these goals (2 to 3 paragraphs)


      ; Current Report Card and Transcript


      ; Birth Certificate and Social Security Card


      ; Copy of parent’s most current Federal Income Tax Form (1040 tax form)
      or a copy of Grant or Benefits Letter


      ; YOU MUST have this statement Notarized

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    • PARENT STATEMENT 

    • PARENT(S) GUARDIAN(S) PLEASE READ BELOW AND SIGN BELOW:


      In applying for a federally funded program, you should know that anyone making false statement or misrepresentation in establishing eligibility is subject to a fine or imprisonment or both under provisions of the U.S. criminal code.


      ; I certify the information provided is correct to the best of my knowledge.

      ; I will participate in all Upward Bound activities requiring my presence and promise to attend at least six parent meetings during the year.

      ; I give consent for my child to use public or private transportation for off-campus activities.

      ; I authorize my child’s high school to release grade reports, transcripts, and any other pertinent material now and throughout the duration of high school to the BCCC Upward Bound Math/Science Program.

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    • PERSONAL GOALS STATEMENT 

    • Describe your educational and life goals, and explain how participating in the BCCC Upward Bound Math/Science Program will help you achieve these goals (2 to 3 paragraphs)


      Essay must be completed by the applicant only without any assistance.

    •  - -

    • Please provide a brief answer to the question listed below.

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