Cuyahoga Community College Upward Bound Math/Science Application

School year (two days a week, 3:30 pm - 6:30 pm)

Summer (Five days a week, 9 am - 3:30 pm for 6 weeks)

The Tri-C Upward Bound Math/Science Program is required to collect information regarding program participants' enrollment and academic performance in high school; and enrollment and graduation from a post-secondary institution for up to six (6) years following their graduation from high school. Information is collected in the form of 8th grade achievement test scores, middle school and high school transcripts, report cards, verbal confirmation of enrollment the first year following high school graduation, and the first semester of their second year following high school graduation.

I hereby grant permission to the Tri-C Upward Bound Math/Science Program to obtain my high school academic information from the Cleveland Metropolitan School District and any other school district that I may transfer to. I also grant permission to the Tri-C UBMS program to obtain confirmation of my enrollment/attendance for two years, after high school graduation, in a post-secondary institution that I may attend. I certify that the information contained in this application and attached forms are true and accurate to the best of my knowledge. I understand that this is an application for a federally funded grant program and that deliberate misrepresentation of my application information may subject me to dismissal from the program. I understand that all information provided in this application will be kept confidential.

Size of Family Unit	Income Level
1	$22,590
2	$30,660
3	$38,730
4	$46,800
5	$54,870
6	$62,940
7	$71,010
8	$79,080

For family units with more than eight members, add the following amount for each additional member: $8,070 for the 48 contiguous states., the District of Colombia and outlying jurisdictions; $10,095 for Alaska; and $9,285 for Hawaii.

the criteria for "LOW INCOME" because there are

members in my family unit and our taxable income does not exceed

The purpose of the Emergency Medical Authorization Form is to enable parents and guardians to authorize the provision of emergency treatment for their children who become ill or injured while under school authority, when the parent(s) or guardians(s) cannot be reached during all activities and team travel related to and associated with the Cuyahoga Community College Upward Bound Math/Science Program.

In the event reasonable attempts to contact me have been unsuccessful, I hereby give consent for: (1) the administration of any treatment deemed necessary by the physician or dentist below, or in the event the designate preferred practitioner is not available, by another licensed physician or dentist, and (2) the transfer of my child to any hospital reasonably accessible, I hereby give consent for the following medical care providers and local hospital to be contacted:

Medical History of my child’s allergies, medications being taken and any physical impairment to which a physician should be alerted:

Authorization does not cover major surgery unless the medical opinions of two other licensed physicians or dentists, concurring is the necessity for such surgery, are obtained prior to the performance of such surgery.

I,

understand that my voluntary participation in TRIO Programs (“Activity”) involves inherent dangers, hazards and risks in which I may be exposed, the RISK OF PERSONAL PROPERTY DAMAGE, BODILY INJURY, AND POSSIBLE DEATH. Understanding fully that these dangers, hazards and risks may be present, I hereby voluntarily agree to be exposed to the inherent dangers and acknowledge that such acceptance is voluntary.

In consideration for my participation in the Activity, I agree to follow the rules and regulations established by the Cuyahoga Community College District (“College”) for safety.  I hereby, on behalf of myself, my heirs, executor, administrator, and assignees, assume all risks associated with my participation in the Activity and agree to hold harmless the College its trustees, officers, employees, agents, and representatives, volunteers, and all other entities acting in any capacity on its behalf  for any and all liability, actions, causes of action, losses, debts, claims or demands of any kind and nature that may result from or in connection with my participation in the Activity, and I release, waive, forever discharge, and covenant not to sue the College, its governing board, officers, agents, employees, and any students acting as its employees (“Releasees”), from and against any and all liability for any harm injury, damage, claims, demands, actions, causes of action, costs, and expenses of any nature that I may have or that may hereafter accrue to me, arising out of or related to any loss, damage, or injury, whether caused by the negligence or carelessness of the Releasees, or otherwise, while in, on, or participating in the Activity.

I assert that there are no health-related reasons or problems which preclude or restrict my participation in the Activity and that I have adequate health insurance necessary to provide for and pay any medical costs as a result of injury to my person, if applicable. 

I also understand and agree that the College may not have medical personnel available at the location of the Activity. I understand and agree that the College is granted permission to authorize emergency medical treatment, if necessary, and that such action by Releasees shall be subject to the terms of this INFORMED CONSENT, RELEASE OF LIABILITY AND INDEMNIFICATION AGREEMENT (the “Agreement”). I understand and agree that the College assumes no responsibility for any injury or damage, which might arise out of or in connection with such authorized emergency medical treatment. In case of emergency, please contact

who can be reached at

I also give my permission to be photographed, and allow the College to release any and all pictures for publicity purposes only. 

I hereby consent to the release of my/my student’s school/college records to the College’s TRIO Upward Bound Math/Science (“UBMS”) program. I understand that these records may include grades and report cards, test results, high school/college transcripts, and financial aid award information. I also grant permission to the Upward Bound Math/Science staff to speak with teachers/counselors/principals at my student’s school in order to obtain and exchange information as part of the services my student will receive through TRIO Upward Bound Math/Science. I further understand that my student’s records will be kept on file in the UBMS office and will be kept confidential.

I agree that if any term or provision of this Agreement shall be held illegal, unenforceable, or in conflict with any law, the validity of the remaining portions shall remain in full force and shall not be affected thereby. I further understand that this Agreement shall be construed in accordance with the laws of the State of Ohio.

I understand that I sign this Agreement as my own free act and deed; no oral representations, statements, or inducements, apart from the foregoing written statement, have been made.  I further state that the participant is a minor and that I am the parent or guardian of the participant and that I am competent to sign this Agreement; and that I execute this Agreement for full, adequate, and complete consideration fully intending to be bound by the same.

THIS IS A RELEASE OF YOUR RIGHTS. READ CAREFULLY BEFORE SIGNING.

Upon my acceptance into the Upward Bound Math/Science Program, my participation will be monitored every sixty days to ensure I am meeting the requirements of the program. As an active participant, I agree to the following actions:

• My parent and I will meet with the Academic Coordinator to design my Student Education Plan (SEP).
• I will complete all required standardized assessments.

• I will attend at least 80% of my scheduled Upward Bound Math/Science Academy sessions per quarter.

• I will attend at least 80% of the scheduled Saturday Workshops per quarter.

• I will attend the Upward Bound Math/Science Summer STEM Academy.

• I will contact the Upward Bound Math/Science office if I cannot attend an activity.

• I will follow all the policies and procedures listed in the Upward Bound Math/Science Handbook.

I will be eligible for my first stipent after I successfully complete sixty days (60) from my first date of service.

The signatures below indicate that we read and understand this agreement and are willing to take the actions listed in this agreement to achieve the goals of this program.

Upward Bound Math/Science

Cuyahoga Community College

2900 Community College Avenue, MCC 000L5

Cleveland, OH 44115

Phone: (216) 987.4927 Fax: (216) 987.6308

http://www.tri-c.edu/ubms

Program Manager, Upward Bound Math/Science
Jan Gholson, Ph.D.		(216) 987.4267
Office Email:		Jan.Gholson@tri-c.edu
Office Assistant, Upward Bound Math/Science
Katiria Cardona		(216) 987.4927
Office Email:		Katiria.Cardona@tri-c.edu
Academic Coordinator, Upward Bound Math/Science
Tina Allen		(216) 987.4956
Office Email:		Tina.Allen@tri-c.edu

Mailing Address:

Cuyahoga Community College

Upward Bound Math Science Program

2900 Community College Avenue

Campus Cener Building, Room MCC 000L5

Cleveland, Ohio 44115

Telephone:	(216) 987-4927
Fax:	(216) 987-6308
Website:	http://www.tri-c.edu/ubms

High Schools Served		Instructional Subject
East Technical High School		English
Garrett Morgan High School		Math
Lincoln West High School		Science

Greetings Upward Bound Math/Science Scholars,

Congratulations, it is with great pleasure that we welcome you to the Upward Bound Math/Science (UBMS) program at Cuyahoga Community College! You have made a good decision and taken the first step to plan and prepare yourself for academic success in high school and college, particularly in Science, Technology, Engineering, and Mathematics, also known as "STEM."

The Upward Bound Math/Science Participants Handbook provides information regarding the program's rules, regulations, and expectations. You are responsible for carefully reviewing and understanding the Participants Handbook and being familiar with the participant's expectations, the Upward Bound Math/Science program, and Cuyahoga Community College rules and regulations.

The Upward Bound Math/Science program strengthens participants' math and science skills. The program aims to help participants recognize and develop their potential, excel in math and science, and encourage them to pursue a postsecondary degree in math and science and, ultimately, careers in math and science professions.

The Upward Bound Math/Science program offers participants valuable skills, strategies, and resources in planning for college. Through workshops, one-on-one advising, college visits, and other activities, participants will gain knowledge and insight regarding financial literacy, financial aid, college and career exploration, standardized testing, basic life skills, and more. Active participants graduate from the program with more substantial academic confidence, maturity, and skills to succeed in college and life.

The Upward Bound Math/Science Staff extends a warm and hearty welcome to each participant and their families. We are here to help and look forward to your success in the Upward Bound Math/Science program. Should you have any questions, please do not hesitate to ask. The best is yet to come!

Warmly,

Dr. Jan Gholson

Program Manager, Upward Bound Math/Science

Upward Bound Math/Science participants may earn awards and stipends for their participation and attendance during the Academic Year and TRIO Summer Academy. The Upward Bound Math/Science Academic Coordinator will assign academic opportunities (tutoring, Saturday workshops, field trips, etc.) to participants during the school year and monitor participation and attendance.

What is a Stipend? A stipend is a fixed sum of money paid as a salary or allowance.

Stipends are distributed tri-monthly (every three months) on a prepaid card. Stipends are calculated based on attendance and the number of completed assignments. Stipend funds will be withheld or reduced as compensation for lack of attendance, damages or losses to equipment, textbooks, incomplete projects, and assignments.

Participants may earn up to $40 per month during the academic year and a maximum of $60 per month during the TRIO Summer Academy. To earn a full stipend from September to May, participants must participate in weekly academic enrichment sessions and monthly Saturday activities and complete other approved activities or alternative assignments.

Stipend criteria include but are not limited to the following:

• In-class participation (minimum 85%)
• Successful completion of assignments, activities, projects, academic, and schoolwork
• Attendance and participation in educational meetings, workshops, and volunteer activities
  • *Note: participants cannot miss more than one activity a month
• Honest and respectful behavior always!

 

The Upward Bound Math/Science staff will make every effort to present participants with educational, social, and cultural experiences and opportunities to earn their full stipend. Participants must make a sincere effort to work hard and embrace their Upward Bound Math/Science experience.

Participants must complete the Academic Year and Summer Components of the program to maintain good standing in both programs

PROBATIONARY PERIOD

All new participants are placed on a 60-day probationary period when they first begin participating in Upward Bound Math/Science during the academic year. In the Summer, all new participants are placed on a 10-day probationary period when they first begin participating in TRIO Summer Academy. Participants will be monitored closely throughout the probationary period and evaluated on attendance, participation, and motivation. Completing the probationary period will result in full access to all rights and privileges of an Upward Bound Math/Science program.

 Holding a "good standing" position allows participants to participate in field trips and cultural events and receive a monthly stipend. Participants must adhere to all Upward Bound Math/Science and Cuyahoga Community College policies and procedures.

 

ACADEMIC YEAR

The academic calendar year for Upward Bound Math/Science is an afterschool pre-college program that provides college prep services. From September to May, we provide services to help participants develop academic skills in Math, Science, and English required to pass the End-of-Course exam.

The integrated curriculum designed explicitly for Upward Bound Math/Science Program includes intensive academic services, curriculum alignment for state testing, and studying and test-taking skills. Participants are also given a pre-ACT assessment for the actual ACT to determine their college readiness benchmarks.

To advance the success of each participant, Upward Bound Math/Science has established academic requirements to maintain good participation and standing in the academic year and summer component.

 

TRIO SUMMER ACADEMY

The TRIO Summer Academy is six weeks during June and July. Participants engage in intensive course work in Math, Science, English, Foreign Language, and Technology, and activities to prepare them for the upcoming academic school year, college, and future careers. Participants and parent(s)/guardian(s) will receive a detailed summer calendar of classes and events.

Active participation, coursework completion, and good attendance are requirements for successfully completing the Upward Bound Math/Science summer academy.

If needed, participants will receive bus passes for travel to and from campus for all Upward Bound Math/Science-sponsored activities and events throughout the academic year and summer components.

 

The TRIO Summer Academy, academic meetings, workshops, and special events are essential to the Upward Bound Math/Science Program. Upward Bound Math/Science aims to provide participants with the necessary knowledge and information to pursue academic success in higher education. Consequently, we have established specific requirements to assist participants in achieving their goals.

 

PROGRAM REQUIREMENTS

These regulations include but are not limited to the following:

• Maintain a minimum GPA of 2.50
• Attend the Upward Bound Math/Science activities for a prescribed number of sessions per week
• Attend all required academic meetings, workshops, and events
• Complete all paperwork, testing, and other assessments as assigned by Upward Bound Math/Science staff
• Arrive on time to Upward Bound Math/Science meetings and events with a positive attitude
• Treat Upward Bound Math/Science staff, teachers, peers, and campus community members with respect at all times
• Participants and parents/guardians will be given a specific date and time for their "Student Education Plan" appointment.
• Participants or parent(s)/guardian(s) must contact the Upward Bound Math/Science office if the participant is absent from a scheduled event/activity.

Suppose the Cleveland Metropolitan School District (CMSD) is closed due to inclement weather, professional days, or another school-sponsored release day; the Upward Bound Math/Science program will also NOT BE IN SESSION.

ACADEMICS

This program aims to provide college prep services and exposure to educational and career opportunities in science, technology, engineering, and math. Participants must sincerely work hard and embrace their Upward Bound Math/Science experience to achieve and advance academically. It is an honor to be selected for this program.

Educational advancement is essential while attending the Academic Year and Summer Program components.

Upward Bound Math/Science has determined that participants caught cheating or plagiarizing during tests on homework assignments or projects will receive disciplinary sanctions as determined by the Upward Bound Math/Science program staff.

• Participants must complete and turn in their work, for example, paperwork, forms, assignments, or other related materials
• Complete mandatory tutoring as assigned

Participants not progressing will be placed on probation and may be suspended from participation in all non-academic Upward Bound Math/Science activities until improvement is achieved.

 

STANDARDIZED TESTING

Standardized tests help to assess participants' academic growth. The program will administer and chart participants' standardized marks annually. The test scores are part of the yearly report the program submits to maintain federal funding. Standardized testing also helps participants develop self-confidence and test-taking skills, increasing postsecondary education's success.

Participants will take the following standardized assessments:

• Accuplacer (All Grades) 

Participants scoring below college-readiness benchmarks will work with the Academic Coordinator to help them develop a Student Education Plan (SEP) to discuss goals, identify opportunities, and refine goals to improve their academic standing.

 

STUDENT EDUCATION PLAN

Participants must complete an individualized Student Education Plan in the fall semester each year. The Student Education Plan is monitored monthly and will identify academic goals, measure outcomes, and recommend services yearly by an Upward Bound Math/Science staff representative.

• Participants and a parent/guardian will be required to meet with an Upward Bound Math/Science staff member to discuss and agree on the Student Education Plan for each academic fall term.

• Participants must identify areas where they would like to receive help and improve.

• The Student Education Plan is a working document; at any point, if changes are needed to the Student Education Plan or the student's required services (at the staff's discretion).

 

TECHNOLOGY POLICIES

During the Upward Bound Math/Science academic year and summer program, cell phones (including but not limited to texting, headphones/earbuds/Air Pods, and music players are prohibited unless otherwise authorized.  

• All phones and electronic devices must be turned off or placed on silent (not vibrate) and stored in a pocket, backpack or purse during any scheduled Upward Bound Math/Science event or function.
• A repeat offense may result in a parent conference, a loss of stipend money, and program dismissal.

 

COMPUTER USAGE AT CUYAHOGA COMMUNITY COLLEGE

• Technology Learning Center computers (TLC) and laptop resources are only for individual learning, class instruction, and research purposes! No web surfing unless it pertains directly to an assignment or research activity, and downloading or streaming any other content is prohibited.
• The computers on campus will be available to all participants throughout the academic year and summer component only with staff supervision.

• No food or drinks are allowed in the Technology Learning Center (TLC) room or near any computer equipment.

• When using campus computers, be courteous to other people using the computers around you. Use headsets when listening to music or watching a video

• Playing internet games such as Yahoo games is prohibited.

• No email, chat rooms, instant messenger, Twitter, Facebook, Snapchat, TikTok, etc., are permitted unless directed by Upward Bound Math/Science staff or instructor

• Absolutely NO visitation to any site is considered inappropriate or pornographic.

• Check your work area before leaving the computer area.

• Remember to collect your belongings (jump drives, flash drives, papers, backpack, etc.), push in your chair and deposit all trash in the appropriate receptacles.

• Technology Learning Center TLC and Library staff monitor sites visited by Upward Bound Math/Science participants.

• Visiting adult or inappropriate sites is unacceptable and a violation of Upward Bound Math/Science and Tri-C Student Codes of Conduct.

• Upward Bound Math/Science staff and instructor monitor participants' activity on computers. 

The dress code is aligned with established school guidelines for appropriate dress. Upward Bound Math/Science Staff will monitor and make decisions regarding proper attire. Use discretion in your choice of clothing. Please be respectful of others concerning clothing that may be suggestive or offensive.

• T-shirts and tank tops with vulgar*, degrading*, or violent* messages and images are considered inappropriate. (No drug/alcohol or violence promotions) Do not wear them to the program or any program activity.

• Undergarments are not to be visible.

• No sagging pants are allowed.

• Shirts and blouses should be modest and appropriate for the school setting. Low-cut tops, bare midriffs, tube tops, spaghetti straps, halter tops, or backless garments are NOT permitted. The bottom of the shirts is to cover the top of the pants on all sides. Skirts, shorts, and dresses are to be modest in length. All clothing must cover and conceal undergarments at all times.

• Using gang symbols, jewelry, paraphernalia, or colors is prohibited.

• Head coverings (except for religious requirements), including but not limited to hats, bandanas, and do-rags, are not to be worn in any building, classroom, workshops, lectures, or on the Tri-C grounds.

• Sunglasses are not to be worn indoors.

"The time is always right to do what is Right!" Dr. Martin Luther King Jr.

Every decision a participant makes has a consequence. Upward Bound Math/Science participants must use good judgment and display a positive and respectful attitude at all functions.

Upward Bound Math/Science is a premier program, and it is a privilege to be selected. The Student Code of Conduct means to keep hands, feet, and objects to yourself and never intentionally harm another student. Always use school-appropriate language and behavior while maintaining friendly and courteous behavior. Be polite and respectful to everyone, including students, teachers, administrators, support staff, and visitors.                                           

Accepted participants have proved exceptional among their peers and know how to conduct themselves appropriately, participate, and respect each other and staff.

Each participant t is responsible for knowing the program rules and upholding these standards through their actions and behavior.

When an Upward Bound Math/Science participant violates academic and behavioral requirements, rules and regulations, or policies or procedures, actions will be taken to align with the college and Upward Bound Math/Science program code of conduct.   

• Disciplinary actions will range from counseling to dismissal.

• Policy standards are based on appropriate academic and safety standards and the Upward Bound Math/Science staff's goal for participants to advance academically and socially.

• Formal Warning: A written notice will be sent to the participant's parent(s)/guardian(s) that the conduct is counter to the expectations, rules, and regulations of the Upward Bound Math/Science program.

• Failure to follow the Student Code of Conduct will require individual consultation with the parent(s)/guardian(s) to establish a resolution.

BEHAVIOR

• Participants shall participate in classroom/tutoring discussions and activities and complete all classwork/homework assignments.
• Public displays of affection are unacceptable. Participants must keep their "hands to themselves." Any inappropriate behaviors will not be taken lightly and will be addressed by the Upward Bound Math/Science staff.
• Participants are strongly encouraged to use the "buddy system"—travel in pairs for safety" while walking across campus, riding the bus, attending field trips, or at any Upward Bound Math/Science event or activity.

EXAMPLES OF DISRUPTIVE/DISTRACTING BEHAVIOR

• Talking during quiet homework room, class sessions, and tutoring
• Immature behavior in the hallways (running, fighting, yelling, profanity, etc.)
• Verbal combativeness with peers, instructors, and staff
• Attending Upward Bound Math/Science unprepared (no supplies, homework, notes, etc.)
• Not paying attention to the instructor or not participating in class discussions or assignments
• Listening to music, sleeping, texting in class or Upward Bound Math/Science activities/events
• Inappropriate comments to participants, staff, or instructors

INCIDENT REPORTS

• Unacceptable behavior will warrant a written incident report, loss of stipend, or possible other sanctions as determined by the Upward Bound Math/Science staff.

• A second incident report will result in a phone call and letter to parent(s)/ guardian(s)/a loss of stipend funds, probation, or dismissal from the Upward Bound Math/Science program.

SANCTIONS

• Sanctions can range from a verbal warning, loss of stipend, probation, mandatory tutoring, loss of privileges, and expulsion from the Upward Bound Math/Science program.
• Probation: Consequences may vary based on the severity violation and circumstances. 
  • The length of probation will depend on the severity of the infraction.

• Suspension of awards or stipends

• Suspension from trips or social activities

• Possible expulsion from the Upward Bound Math/Science program

• The Upward Bound Math/Science staff will apply sanctions as deemed appropriate.

ZERO TOLERANCE POLICY

These non-negotiable violations will result in termination from the program during the academic year or summer component. These regulations include, but are not limited to, the following:

• Possession and use of weapons, alcohol and other drugs, contraband, and tobacco
• Sexual misconduct
• Leaving campus without permission from the Upward Bound Math/Science staff
• Any criminal code violation of Ohio revised statutes (http://codes.ohio.gov/orc/)
• Fighting (In school or the Upward Bound Math/Science program)

PROHIBITED

Prohibited items will be taken from the participant and locked in a secure place until the end of the Upward Bound Math/Science event/activity. 

• Cell phones/electronic devices/headsets must be turned off and put away during ANY Upward Bound Math/Science activity or event; unless otherwise stipulated by an Upward Bound Math/Science staff member.

• Gambling for personal profit/loss is prohibited.

• Verbal and physical intimidation, bullying, and fighting are prohibited.

   

• Derogatory, unpleasant, insulting gestures and vocabulary are prohibited.

ACCOUNTABILITY STANDARDS

Accountability standards have been established for the Upward Bound Math/Science Program as a natural progression of a success in postsecondary education. We have set standards to equip our participants to understand and appreciate responsibility and accountability in their success.

LEADERSHIP STANDARDS

Leadership standards established are based on participants' understanding of their ability to lead in accepting diverse people within their school, community, and world. Participants actively participate and contribute during M/S Academy, academic meetings, workshops, and special events. Participants will be encouraged to serve as student ambassadors in their school and community, volunteer, and work as office aides or peer tutors. Our goal is for participants to develop a proactive approach in viewing their responsibilities to identify how to make better choices for their future.

Our accountability and leadership standards provide tools (used as a means of achieving) for participants to create success -- from attendance, social aptitude, study skills, and time management to help participants understand their goals, talents, abilities, and gifts. These standards enable participants to build a foundation for successfully managing their lives. Participants learn teamwork and effective social and emotional techniques to build positive relationships and empathy for others in high school, college, and the community. 

 

Accountability + Leadership = Success

I have read and fully understand each section of the Upward Bound Math/Science Program Handbook. I understand that participants in the Upward Bound Math/Science program are required to be college-bound participants, i.e., students planning to enroll in college after high school graduation. I clearly understand the expectations and requirements of the Upward Bound Math/Science Program. I clearly understand the consequences of not following through with the stated requirements, rules and regulations, and policies and procedures outlined in this handbook. I also know that I can be terminated from the Upward Bound Math/Science Program for not following through with Program requirements and expectations.

By signing this contract, I am committing to complete the Cuyahoga Community College Upward Bound Math/Science experience in its entirety, both the academic year and summer component.

Parent(s)/Guardian(s) Commitment to Upward Bound Math/Science Program

As the parent(s)/guardian(s) of the above-name participants, I/we commit to supporting the administration and staff of the Upward Bound Math/Science Program in providing a safe and educational program for my/our participants. I/we understand that my/our student's success in this program is my/our responsibility and my/our student's. I/we accept that responsibility and fully support the program curriculum. I/we will strongly encourage my/our child to complete the program in its entirety.

By signing this document, I/we align myself/ourselves with my/our student for their success in the Upward Bound Math/Science Program at Cuyahoga Community College.

Upward Bound Math/Science-Funded by The U.S. Department of Education—$250,000/100% Sponsored by Cuyahoga Community College.