Independency:
Note: taxable income (Adjusted Gross Income) can be found on the federal income tax return (IRS Form 1040, line 43; on IRS Form 1040A, line 27; IRS Form 1040EZ, line 6)
Mother / Guardian #1:
Father / Guardian #2:
Note – All services are provided free-of-charge & 100% of UB’s costs are financed with Federal funding. Please visit https://gulfcoast.edu/trio for additional disclosures UB is required to provide prospective participants and parents.