Pima Community College-Downtown Campus-UB-Application Form Logo

  • Pima Community College- UPWARD BOUND APPLICATION

  • Pima Community College Upward Bound (UB) Downtown Campus
    1255 North Stone Avenue Tucson, AZ 85709-3140
    Email: PCC-TRiO-DCUB@PIMA.EDU Phone: 520.206.7073 Fax: 520.206.7022

     

    This project is funded by the United States Department of Education (ED) The personal information you give to the Upward Bound program is kept on file for the federal government (ED). The information is protected by the Privacy Act. No one may see the information unless they work with or for the Upward Bound project or are specifically authorized to see the information. The information is necessary to determine if you are eligible to participate in the program and helps the government to measure our success. The Department of Education has the authority to gather information to help make Upward Bound a better program. 

    Reasonable accommodations, including materials in an alternative format will be made for individuals with disabilities when a minimum of five working days advance notice is given.

     

    Pima Community College Downtown Campus

    Upward Bound

    New Student Application Requirements

     

    In addition to the application, you will also need to provide the following documentation before your application is considered complete. 

    Please contact our office at 520.206.7073 when you have questions or need clarification.

    ALL INFORMATION WILL BE HELD IN STRICTEST CONFIDENCE

     

      Item Needed for Application Explanation of Item Needed for Application
     

    Income Verification

    (Signed Tax Forms)

    		 YOU MUST complete the income information section of this application You may also submit your Income Tax Return Form (1040 or 1040A) from the previous year’s taxes. For the tax return we need the first and second sheet to determine the number in your family and taxable income. This information is required by federal regulations to determine student’s eligibility.
     

    Proof of Residency or Citizenship

    Submit a copy of one of the following forms:

    • Birth Certificate
    • US Passport
    • Permanent Residency Card

    This information is required by federal regulations in order to determine a student's eligibility.
     

    Recommendation

    2 Teacher/Coach/Sponsor

    Counselor

    		 You will need 3 personal recommendations.  One recommedndation must be from a high school counselor.  The other two recommendations may be from a teacher, coach, or sponsor.  Send each person the recommendation form link.
      Once we have reviewed your application a Parent/Family Interview will be scheduled You and your parent(s)/guardian(s) will be required to schedule an interview with the Upward Bound Staff in person, at this time please bring all required documentation
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    • STUDENT INFORMATION: 
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    • Ethnic background:

    • STUDENT RESIDENCY STATUS: 
    • STUDENT ELIGIBILITY CRITERIA: 

    • (or)

    • (or)

    • STUDENT INVOLVEMENT: 
    • FAMILY INFORMATION: 

    • First Generation Status: Parent/Guardian Education Level

    • Low-Income Status

    • *(I.e. WIC, AHCCCS, Food Stamps, free/reduced lunch)

    • The TRIO Upward Bound (UB) Program is funded by the U.S. Department of Education. The program is designed to encourage and prepare participants to attend post-secondary education. All information is strictly confidential and is used solely for the purpose of determining the eligibility of students applying for participation in the UB Program. All applications are accepted for review regardless of race, color, national origin, religion, gender, or disability (U.S. Dept. of Education-GEPA Section 427).

      Both student and parent signatures are required in order to process the application.

      We, student and parent/guardian, understand TRIO UB is a federal program authorized by the U.S. Department of Education. We also understand that the information provided will be used to document student eligibility for the program. We certify that all the information on the New Student Application and all sections provided is accurate and true.

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    • LONG ANSWER QUESTION: 

    • Students, in the space provided, please answer the following questions. Your answers will help the Upward Bound Staff learn more about you and determine your need for the program.

    • Program Commitment

    • Academic

    • Self-Concept

    • Postsecondary Enrollment and Retention

    • PERSONAL ESSAY: 
    • PROGRAM COMMITMENT: 

    • I understand that my involvement includes:

      ♦ My participation in a half-day Saturday program 12 times during the academic year for the remainder of my high school experience

      ♦ My fulfillment of all requirements of UB – attendance, cooperation, grades, tutoring, goals – while a member

      ♦ My participation in a six-week summer program for the remainder of my high school experience

      ♦ My enrollment in college preparatory classes at my high school (university track)

      ♦ My enrollment in and my commitment to complete a program of study in post-secondary education;

      I hereby apply for admission to the Upward Bound Program at the Downtown Campus of Pima Community College and agree to abide by the rules and regulations set forth by the program. I understand that should I be accepted, I will remain in the program throughout my high school years and will continue and complete a course of study beyond high school.

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    • PARENT QUESTIONARE: 

    • This page should be completed by the parent(s) or guardian(s). Please fill in a response for each question that corresponds to your feelings/opinion. Your answers will be used to help determine your child’s acceptance into the Upward Bound Program.
      SA =Strongly Agree, A = Agree, N= Neutral, D = Disagree, SD = Strongly Disagree.

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    • Submit 
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