2025-2026 New Student Application

The U.S. Department of Education requires the collection of the following data to determine student eligibility. Failure to provide the necessary supporting documents will disqualify your application from consideration.

The information you provide to the UB program is confidential and is protected by the Privacy Act of 1974 (5 U.S.C. 552a).

NOTE: If the student is independent or in foster care, the parental income information is not required. Written verification of a student's status may be required.

The personal essay is an important part of the selection process. In at least 250 words, please type your essay in the space provided below.

This essay must be in your own words. AI-generated responses will not be accepted, as this application values authenticity and genuine personal experiences. Submitting an AI-generated response will render your application incomplete, requiring you to reapply.

Choose ONE of the following questions

1) What motivates you to apply to the UBMS program? What benefits do
you hope to gain from this experience, and how do you plan to contribute
to the program?

2) What events or individuals in your background have influenced you in
your educational and career goals?

3) Discuss a personal, local, national, or international issue that concerns
you.

4) What are your dreams for the future?

In accordance with the TRIO Upward Bound Program eligibility requirements set forth by the U.S. Department of Education, I hereby certify and attest under penalty of perjury that the information I have provided on this application is true and correct to the best of my knowledge.

I authorize Pima Community College, Downtown Campus, and UB program access to my student's academic and personal information through the school or district database and/or to receive copies of transcripts, test scores, and any other information that may be necessary for participation in the program. I further authorize the staff of Pima Community College, Downtown Campus, and UB program access to my student's college enrollment, retention, and completion information, as well as financial aid information from colleges and the federal government.

I further certify that I am aware that the provision of any false, fictitious, or fraudulent information or the omission of any material fact may subject me to criminal, civil, or administrative penalties for fraud, false statements, false claims, or other violations.

(U.S. Code Title 18, Section 1001; Title 20, Section 1097; and Title 31, Sections 3729-20 and 3810-3812). The following consent shall be valid for the entire duration of my son/daughter's participation in the UB program and until completion of a bachelor's degree, or for 6 years following graduation from high school.

I hereby grant permission for my son/daughter to participate in the Pima Community College, Downtown Campus, UB year-round programming. I also give my consent for the following:

■ The high school staff and administration will grant access to the UB staff to my student's academic records (class schedules, test scores, transcripts, attendance, etc.)
■ For the UB staff to obtain documentation verifying an applicant's U.S. citizenship, or national permanent resident status, or of his or her intent to become a permanent resident.