Kilgore College-UB-Parent Application

2024-2025 Parent Application for Student Admission

Kilgore College Upward Bound
Federal TRiO Program
Funded by the U.S. Department of Education (ED)
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Kilgore College

TRIO Upward Bound

1100 Broadway BLVD, Student Support 214

Kilgore, TX 75662

Office: 903-988-3760

Upward Bound is a Federal grant program funded by the Department of Education. The goal of Upward Bound is to increase the rate at which participants complete high school, and enroll in and graduate from institutions of postsecondary education (college/university). This year-round college-prep program is free to students who qualify.

Upward Bound serves:
1. High school students whose parents’ or guardians’ income meets federal income guidelines; and/or
2. high school students from families in which neither parent holds a bachelor's degree (first-generation students).
If you meet these requirements, Kilgore College Upward Bound welcomes your application for our program.

The Kilgore College Upward Bound Program serves students each year from Kilgore High School, Longview High School, and Pine Tree High School. Please take time to read this information and understand the contents in order to decide if this program will be a good fit. Students must participate in the academic year program and a six-week summer program, both of which are held on Kilgore College’s campus. KC UB students may use the KC Library, fitness center, and other facilities on campus.

The UB Academic Year Program consists of UB Saturdays held once per month where students may attend academic classes, cultural exploration events, meet for college campus visits, career exploration, and/or volunteer opportunities. Most UB Saturdays will be held at Kilgore College. Classes can include current high school academic subjects as well as test preparation and test-taking, financial literacy and financial aid, mental health, etc. Students are provided access to tutoring through Fall and Spring.

In the Summer Academy, participants attend intensive academic instruction on the KC Kilgore campus for a six-week period. Some career, educational, or cultural field trips may be scheduled during this time, as well as some recreational activities.

If interested in applying for this program, please read and follow these instructions carefully:

Application Process

Student Application must be completed in addition to the Parent Application. Both applications can be found at www.kilgore.edu/upwardbound.

STEP 1: Completion of this application will help us to determine participant eligibility, but it does not guarantee acceptance into the program. Eligibility is based on the following items:
- Plan to attend and complete college after high school.
- Attend Kilgore High School, Longview High School, or Pine Tree High School, and must have completed the eighth grade.
- Cumulative GPA 2.5 or above is required.
- Come from families that are income-eligible and/or first generation.
Once our program reaches its target number, the program will be closed for the year. Additional applications will be kept on file for the current school year. Please make sure your application is completely filled in with the appropriate documents attached.

STEP 2: Participants and parents will be required to attend an interview with the program staff and sign the Participation Agreement. A list of program dates and activities will be provided.
UB Parent Application (To Be Completed by Parent/Guardian):
Child's Date of Birth*

MonthDayYear
Date
Student's Name:*

First NameLast Name
Current School & Grade Level:*
Current School District*

Kilgore ISDLongview ISDPine Tree ISD
Grade Level for 2024-25 Academic Year*

9101112
Who does student live with?*

Two parents (or parent and stepparent)MotherFatherGuardianOther
Parent 1 Name:*

First NameLast Name
Parent 1 Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent 1 Phone Number*
(999)999-9999
Parent 1 Cell Phone Number:*
(999)999-9999
Parent 1 Email Address:*
example@example.com
Parent 2 Name:*

First NameLast Name
Parent 2 Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent 2 Phone Number*
(999)999-9999
Parent 2 Cell Phone Number:*
(999)999-9999
Parent 2 Email Address:*
example@example.com
Has either parent received a bachelor's (4-year) degree from a U.S. college or university?*

YesNo
I certify that the information provided on this form is true and complete to the best of my knowledge.
Parent's Signature:*

Clear
Date:*

MonthDayYear
mm-dd-yyyy
Academic Records Authorization
I authorize the Upward Bound Program of Kilgore College to access Skyward and/or receive copies of my student’s academic transcripts, grade reports, report cards, STAAR scores, and any other academic information and test results necessary to complete the program’s application process.
Parent's/Guardian's Signature:*

Clear
Student's Name:*

First NameLast Name
School:*
The Family Educational Rights and Privacy Act (FERPA), 20 U.S.C. §1232g, and the Texas Public Information Act, Texas Government Code §552.001 et seq., are respectively federal and state laws providing for the review and disclosure of student educational records. The University and Outreach Programs-TRIO and GEAR UP will not permit access to or the release of personally identifiable information contained in student educational records to any party without the written consent of the student, except as authorized by FERPA.
UB Parent Statement of Commitment
I understand the purpose of the Upward Bound Program which is to prepare participants to successfully complete a program of post-secondary education (college) and would like to have my child participate.

Parent involvement and support are major contributing factors to student success.
- I support the mission of Upward Bound and will make it a priority to assist my child in his/her education.
- I will ensure my child has transportation to and from all scheduled UB events, will arrive early or on-time, and will be picked up on-time.
- I will attend semester orientations (1 per term) and other scheduled events where my presence is requested.
Acting as the applicant’s parent and/or legal guardian we all agree and understand that the applicant will participate in the following ways if he/she is accepted into the program:
- The student will attend advising sessions at their high school with their academic coordinator.
- The student will attend all weekend and summer programming held on the Kilgore College campus.
- The student will participate in the Upward Bound Program through high school graduation.
- The student will enroll in a university or community college in the semester following high school graduation.
By my signature, I agree to the above statement of commitment.
Parent Signature:*

Clear
Date:*

MonthDayYear
mm-dd-yyyy
Income Verification
Please check one of the following in the chart below to indicate your TAXABLE INCOME (Line 15) shown on your most recent 1040 tax return (NOT GROSS INCOME).
Most Recent Tax Year*

$0 - $21,870$21,871 - $29,580$29,581 - $37,290$37,291 - $45,000$45,001 - $52,710$52,711 - $60,420$60,421 - $68,130$68,131 - $75,840DID NOT FILE
Please provide income information for 2023. Upward Bound must verify income to determine eligibility and for acceptance into the program.
Number of people listed in household on 2023 tax return? *
What is your taxable income* for 2023? *
* Please note that taxable income is lower than adjusted gross income (AGI) and can be found on most tax returns. Taxable income is found on line 15 of the IRS Form 1040 US Individual Income Tax Return. Please get in touch with us if you do not file taxes or have questions about locating this information.
Please provide income information for 2022. Upward Bound must verify income to determine eligibility and for acceptance into the program.
Number of people listed in household on most recent tax return:*
All of the information on this form is true and complete to the best of my knowledge.
Parent(s)/Guardian(s) Signature:*

Clear
Date:*

MonthDayYear
mm-dd-yyyy
Student's Name:*

First NameLast Name

UB Parent Application (To Be Completed by Parent/Guardian):

Academic Records Authorization

UB Parent Statement of Commitment

Income Verification