University Of Minnesota-Minneapolis-Twin Cities-UB-2024 Application Form

University Of Minnesota

Upward Bound

Section 1: About TRIO Upward Bound

What is TRIO Upward Bound, University of Minnesota?

TRIO Upward Bound (TRIO UB) at the University of Minnesota’s College of Education and Human Development is a pre-college US Department of Education federal grant program. We offer year-round, intensive and holistic college-readiness skill building for 118 Minneapolis youth at North, South, Camden, and Edison high schools who come from low-income backgrounds and who are potential first-generation college bound students. Our goal is for students to not only get into college, but to earn a college degree. We have been serving MPS since 1966.

Who may apply?

Enrolled in one of our target high schools: Edison, North, South, or Camden
Are in the 9 th or 10th grade. Some 11th graders may apply
Have a current grade point average of 2.5 or above
Be a first-generation college bound student; neither parent has a 4-year degree
Student is a U.S. citizen or permanent resident of the United States
Studnet is in an income-eligible family (typically students that qualify for free or reduced lunch). A family meets the income eligible guidelines if their taxable income for the preceding year did not exceed 150% of the poverty level
Have an academic need

What about cost?

Services and activities are FREE to participants and their parents/guardians.
Participants can earn a small monthly performance stipend (money).

What services do students receive from TRIO UB? We provide year-round, holistic, intensive, and long term academic and college preparation.

Program Services

Academic Year Program October - May	Summer Program June - August
Weekly after school classes Tutoring (Monday - Thursday) Financial aid & literacy workshops College visits & field trips Leadership development opportunities Educational workshops for parents/families Scholarship opportunities ACT preperation Career Exploration	5 Weeks of academic classes Monday - Friday 3 weeks of living in the dorms at the University of Minnesota Twin Cities Experimental & cultural activities Community service opportunities 3-day Regional College tour 6-day wilderness retreat 6-week "Bridge" program for recent TRIO UB graduates; an opportunity to earn college credit

Application Checklist & Timeline
- Student & Parent Application
- MPS Permission to Release Information Form
- Two Teacher Recommendation Forms (Science, Math, English, or History)
Please select if applicable:

I have read the section above

Section 2: Student Application
A: Applicant Contact Info & Demographics
Student Legal Name (as printed on Social Security ID) required*

First NameMiddle InitialLast Name
Preferred Name:
Pronouns:
Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Cell Phone:*
(999)999-9999
Home Phone:*
(999)999-9999
Personal Email:*
example@example.com
Highschool Email: *
example@example.com
Sex:*

MaleFemaleOther
Date of Birth:*

MonthDayYear
mm-dd-yyyy
Are you a U.S. Citizen?*

YesNo
If No, what country were you born in?*
Are you a Permanent Resident? (If not a citizen)*

YesNo
If Yes, please attach copy of your Permanent Resident card (both sides)

Cancelof
Ethnicity/Race: Check all that apply to you.*

Native Hawaiian / Pacific IslanderHispanic / LatinoAmerican Indian or AlaskanAfrican American / BlackAsian American / AsianCaucasian / White
B: Family & Educational Background
What languages do you speak and/or spoken in your home?
Primary Language: *
Secondary Language:
What High School do you currently attend?*

EdisonCamdenNorthSouth
Current Grade:*

91011
Name of High School Counselor:

First NameLast Name
Are you enrolled in an ESL or ELL class?*

YesNo
If yes, please list:
Do you have an IEP or 5O4?*

YesNo
If yes, please list:
C: Extra-Curricular & After School Commitments

What extra-curricular activities are you currently involved in or plan to join (if it doesn't apply write N/A) *

	Extra-curricular	Days(s) of the week?
Sport(s):
Music:
Club(s):
Faith/Religious:
Other:

Do you have a job?*

YesNo
If yes, what is the name of your employer?
What days do you typically work?
How many hours a week?
How will you balance TRIO Upward Bound with your afterschool activities, work, and home life?*
Have you ever been in a TRIO Upward Bound, Educational Talent Search (ETS), or GEAR UP?*

YesNo
If yes, where and when?
Can you commit to participating in TRIO Upward Bound Summer Program each summer, including:
- Five weeks of summer academic enrichment classes Monday – Friday, June and July each summer
- Stay overnight in the residence halls at the University of Minnesota Twin Cities for three weeks, AND
- Participate in college tours, service trips, and class trips
Can you commit...*

YesNo
D: Student Questionnaire & Essays
List two non-academic (not school related) facts you want TRIO Upward Bound staff to know about you (1 sentence each):
1.*
2.*
Why do you want to join TRIO Upward Bound? How will TRIO Upward Bound help you? (write 3-5 sentences)
TRIO Upward Bound offers a variety of services to increase your knowledge and skills. Which of the following interests you? Check all that apply.*

Communicate better with my familyLearn to express emotionsSet and accomplish goalsDiscover my strengths and weaknessesDevelop public speaking skillsCommunicate my feelingsLearn to be less shy and/or make new friendsLearn how to manage stressDiscover possible careersLearn how to make decisionsDevelop leadership skillsExperience cultural and social eventsParticipate in recreational activitiesImprove study skillsImprove test taking skillsCommunity service opportunitiesLearn how to resolve conflictsLearn advocacy skillsOther
How did you hear about TRIO Upward Bound?*

School Counselor or TeacherCommunity OrganizationParent/Guardian or Family MemberCurrent Student at TRIO Upward BoundTRIO Upward Bound Staff
In 10 years, where do you see yourself? Why do you want to earn a college degree? How will you get there? (write 3-5 sentences)*
Who inspires you to achieve more in your academics and what is their message to you? (write one paragraph (3-5 sentences))*
E: Recommendations
To complete your application, you will need two recommendations. One should be from a core course (English, Math, Science or History) and one from any core class or elective class (music, language, gym, etc.).

Please send the following links to your desired teachers to fill out: https://botform.compansol.com/242685181532054, https://botform.compansol.com/242694280799877
Please check if applicable:

I have read the recommendations section above and I will send the link to two of my teachers.

Section 3 Parent Application
A: Household information
HOUSEHOLD STATUS of Student’s Home (CHECK ALL THAT APPLY):*

Two ParentsLives with FatherFoster HomeSingle ParentLives with MotherDivorced/ Separated Parents (circle one)Group HomeOther
Name of Parent/Guardian 1:*

First NameLast Name
Parent/Guardian 1 Phone Number:*
(999)999-9999
Parent/Guardian 1 Email:*
example@example.com
Name of Parent/Guardian 2:

First NameLast Name
Parent/Guardian 2 Phone Number:
(999)999-9999
Parent/Guardian 2 Email:
example@example.com
Answer the following as completely as possible. If parent #2 address is the same, write “same”. If something doesn’t apply, please put “n/a”. First Generation status of a student is based on the educational level of student’s biological parents. If biological parents are not actively involved in student’s life then fill information out to best of ability.

Note: This section only determines income eligibility in accordance to federal guidelines. The following information must be about the student’s biological parents not including step parents or legal guardians.
BIOLOGICAL PARENT #1
Relation to Student:*

MotherFatherParent
Biological Parent?*

YesNo
Biological Parent Name:*

First NameLast Name
Did this parent receive a Bachelor’s Degree?*

YesNo
BIOLOGICAL PARENT #2
Relation to Student:*

MotherFatherParent
Biological Parent?*

YesNo
Biological Parent Name:*

First NameLast Name
Did this parent receive a Bachelor’s Degree?*

YesNo
B: Income Verification
Overview: The following is a guide showing the maximum amounts families can earn to be eligible for Upward Bound services. The U of MN TRIO Upward Bound (UB) program is sponsored by a grant from the U.S. Department of Education (DOE). Federal regulations require that UB participants meet certain family income guidelines. The income information required will be held in the strictest of confidence and is available to no one except the DOE representatives for audit purposes. All requested income documentation is required to complete the application.
INCOME DECLARATIONS
On your taxes, what is the reported size of your family? (ex. 1,2,3....)*
1) TAX INFO: Did you file a FEDERAL INCOME TAX (1040, 1040A, 1040EZ) for last year in 2023?*

YesNo
If you answered YES, and filed taxes last year (Option 1): Report your family’s 2023 taxable income: (*On the 2023 federal tax forms, find taxable income on the following lines: 1040EZ, Line 6, 1040A, Line 27, Form 1040, Line 15)*
$

Exceptions: Eligibility for Upward Bound is based on your taxable income from the previous year, but in special cases it can be based on this year’s income. Has your family’s financial situation changed recently for the worse because of serious illness, disability, death, separation, divorce, or loss of a job benefits?*

YesNo
If “yes”, explain:
Does your family qualify for the free or reduced lunch program in school?*

YesNo
Does your family live in federally supported low-income housing?*

YesNo
Certification: All the information on this STATEMENT OF INCOME is true and correct to the best of my knowledge and my family in 2023 income is below the 150% federal guide. If asked by an authorized official, I agree to give proof of the information that we have given on this form. I also realize that purposely giving false or misleading information on thisform may result in a fine, a prison sentence or both. I also realize that if I do not give proof when asked, my child will be denied admittance to TRIO Upward Bound at the University of Minnesota.
Parent/Legal Guardian Signature*

Clear
Date*

MonthDayYear
mm-dd-yyyy

	Monthly Amount: $
Job/Employment income Monthly Amount:
Public Welfare/Assistance (SNAP, WIC, etc.) Monthly Amount:
Social Security Monthly Amount:
Veterans Benefits Monthly Amount:
Child Support/Alimony Monthly Amount:
Pension/Retirement Monthly Amount:
Unemployment Monthly Amount:
Other:
TOTAL Yearly Income:

Section 4 Student and Parent Release form
PERMISSION TO RELEASE INFORMATION
Student Name*

First NameLast Name
Birth Date:*

MonthDayYear
mm-dd-yyyy
Grade*
Parent or Guardian Name*

First NameLast Name
District: Minneapolis Public Schools
Student ID #: *
School:*

EdisonCamdenNorthSouth
Minneapolis Public Schools has my permission to release educational data (including transcripts, grades, test scores, attendance records, IEP/504 plans, disciplinary action write ups, Naviance records, etc.) to the University of Minnesota, College of Education and Human Development (CEHD), TRIO Upward Bound Program (TRIO UB). This release is valid from the date of signature until my student graduates high school. I understand that this release may be revoked at any time in writing.

I understand that this information will be used in determining admission to the program and in planning my student’s academic programming once admitted to the TRIO Upward Bound program at the University of Minnesota.

TRIO Upward Bound will use the educational data for the following reasons:

1. TRIO Upward Bound must report students’ progress to the U.S. Department of Education to demonstrate program effectiveness.
2. Upon request, TRIO Upward Bound will report students’ progress to the Minneapolis Public Schools to assist counselors and teachers to serve TRIO Upward Bound students better.
3. To connect TRIO Upward Bound students to scholarship agencies, youth leadership, employment, educational and other programs.
4. To obtain college admission and financial aid application fee waivers.
5. To discuss admission and financial aid opportunities with educational professionals.
6. Permission to participate in TRIO Upward Bound approved research projects designed to improve services and identify areas where TRIO Upward Bound students need assistance.

We (student and parent/guardian) have read the above information and understand that this consent takes effect on the date of signature.
Student Signature:*

Clear
Date:*

MonthDayYear
mm-dd-yyyy
Parent/Guardian Signature:*

Clear
Date:*

MonthDayYear
mm-dd-yyyy
Students under the age of 18 must have a parent or legal guardian signature.
I agree that, to the best of my knowledge, the information given on the application is true, complete and accurate.*

I agree

University Of Minnesota

A: Applicant Contact Info & Demographics

B: Family & Educational Background

C: Extra-Curricular & After School Commitments

D: Student Questionnaire & Essays

E: Recommendations

A: Household information

B: Income Verification

PERMISSION TO RELEASE INFORMATION