Florida Atlantic University-UBMS-Application Form

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Dear Applicant,

Thank you for your interest in the Upward Bound Programs at Florida Atlantic University. Upward Bound and Upward Bound Math & Science are federal programs designed to help students with academic potential who need additional preparation and motivation to prepare for, enter, and succeed in college. The programs provide ongoing academic support, counseling, post-secondary preparation, cultural enrichment activities, and a UBMS summer bridge program - all at no cost to the students or the school! The Upward Bound Programs are year-round programs.

Eligibility to participate in the program is determined individually. However, each applicant must meet basic eligibility requirements set forth by the federal government, that require neither parent to have a four-year college degree and family’s income level verification. Our program is open to students who are entering grades 9, 10, 11 & 12. FAU Upward Bound Programs have limited space available. Therefore, it is important that you complete your application as soon as possible. In the event there is no program space availability, an approved student will be placed on a waiting list for later consideration.

There is six-week summer enrichment including a one-week residential program. UB participants have an opportunity to take academic preparation courses in Math, Language Arts, Science, and Foreign Languages, Co-Curricular Workshops, and Summer Bridge Program (UBMS) ONLY. For more information, please call our office.

Below you will find instructions for completing the application process. Once your application is received, you will be notified of your application status. We look forward to serving you!

Sincerely,

Pamela King, Director of Upward Bound Programs

Pking3@fau.edu

3200 College Avenue I ES Bldg. I Fort Lauderdale, FL 33314 I Phone: 954-236-1318 I Fax: 954-236-1341

Name*

First NameLast Name

School*

Student ID*

Grade*

Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Student Phone*

(999)999-9999

Student E-mail*

example@example.com

Date of Birth*

mm-dd-yyyy

Gender*

MaleFemale

Ethnicity?*

Current Unweighted GPA*

Have you passed all required EOC's?*

YesNo

Have you passed the FSA?*

YesNo

Place of Birth*

US Citizen?*

YesNo

Please provide your Resident Registration Number*

How can the Upward Bound Programs assist you as a participant? (Please check all that apply)*

Are you CURRENTLY ENROLLED in any other TriO programs?*

Upward BoundUpward Bound Math & ScienceEducational Talent SearchNever enrolled

Parent Name*

First NameLast Name

Phone

(999)999-9999

E-mail

example@example.com

First Generation Eligivility Verification

*Please note that income level Is only one factor for eligibility and will not be the only factor of acceptance into the program.

Please indicate the highest educational reached within household (Either Parent / Guardian)*

How many people live in your household?*

Parent's / Guardian 's yearly adjusted gross income is*

Parent/Guardian Signature*

Date*

mm-dd-yyyy

UBMS Application

Student Information

Parent Information

Parent/Guardian Income Affidavit

Household Income