Volunteers of America, Los Angeles (VOALA) Upward Bound (UB)

Student Agreement:
As a participant in VOALA Upward Bound, I understand that I am making a commitment to the program until I have graduated from high school. My commitment includes:

• Enroll in postsecondary education the fall semester/quarter following high school graduation
• Complete weekly tutoring hours
• Attend grade-specific summer programs each year enrolled in the program
• Participate in student academies
• Meet with TRIO Program Staff to discuss academic progress
• Participating in UB activities such as field trips, college and career workshops, SAT prep courses, etc.

A parent, guardian, or other adult legally responsible for the application must complete this page.

Parent/Guardian Education

Adjusted Gross Income: Adjusted gross income is defined as gross income minus adjustments to income. Gross income includes your wages, dividends, capital gains,
business income, retirement distributions as well as other income.

Taxable Income: Taxable income is the amount of money earned after exemptions and deductions. Taxable income includes wages, salaries, bonuses, and tips, as well as investment income and various types of unearned income.

I did not/will not file an income tax return for the last calendar year

I attest that the information stated above is true and accurate, and understand that the above information, if misrepresented, or incomplete, may be grounds for the student’s dismissal from Upward Bound and/or require repayment of all cost incurred for services rendered to the family.

I give the Volunteers of America, Los Angeles Upward Bound (VOALA UB) program permission to obtain any school or financial records of my participant to determine eligibility for the program and to monitor the student’s academic progress. In addition, I give my permission for my child’s name, photograph, work and/or statements to be used by VOALA UB for promotional, publicity or instructional purposes.

I authorize Volunteers of America, Los Angeles Upward Bound to have access and to and obtain copies of school records for the above-named applicant. Access to academic records may include, but are not limited to the following:

• Class Schedule
• Transcript
• Standardized Test Scores
• Individualized Educational Plan (IEP)
• Attendance Data
• Verification of Enrollment (Secondary and Post-Secondary)
• Degree Verification (Secondary and Post- Secondary)
• Any additional information needed by the Upward Bound Program to complete the Annual Performance Report required by the U.S. Department of Education
• Any additional information deemed necessary by the Upward Bound Program needed to make decisions regarding the applicant’s secondary and post-secondary education

For the purpose of program completion of the Annual Performance Report (APR), I authorize the release of school records from the district of the above-named applicant, grade six through the completion of post- secondary education to Volunteers of America Los Angeles.

I have reviewed the above documentation and verify that the information is true
and correct to the best of my knowledge.