334252-Sonoma State University-UB 4-Application Form-Stephen

2025-2026 New Student Application

Sonoma State University Upward Bound North (UBN)
Sonoma State University Pre-Collegiate Programs
1801 E Cotati Ave, Rohnert Park, CA 94928-3609
Have questions? Contact us!
Email: cripe@sonoma.edu Phone: 707-664-2008 Website: https://precollegiate.sonoma.edu/

New Student Application Requirements

For a complete UB application, please make sure to include the following:
- Completed Student Application, including Income Verification section
- Personal Statement and Short Answer Questions
- Two letters of recommendation (send this link to two recommenders of your choice)
If your application is moved to the next round, we will reach out to schedule a student/family interview.
- Student Name:*
  
  First NameMiddle NameLast Name
- Preferred Name:*
- Preferred Pronouns:*
- Mailing Address:*
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip Code
- Student Cell Phone: *
  (999)999-9999
- YesNo
- Parent/Guardian Cell Phone:*
  (999)999-9999
- YesNo
- Student Personal Email (NOT School Email): *
  example@example.com
- Student's Date of Birth: *
  
  MonthDayYear
  mm-dd-yyyy
- MaleFemale
- American Indian/Alaskan NativeAsianBlack/African American NativeHawaiian/Islander WhiteHispanic/LatinoOther
- Both parentsMother onlyFather onlyGuardianFoster Parent
- YesNo
- Preferred language: *
- YesNo
- If yes, please list: *
- U.S. CitizenU.S. Permanent Resident
- School I currently attend: *
- Grade: *
- YesNo
- Full Name:*
  
  First NameLast Name
- Email Address:*
  example@example.com
- Relation to applicant:*
- Full Name:*
  
  First NameLast Name
- Email Address:*
  example@example.com
- Relation to applicant:*
- Has your parent/guardian received a Bachelor's Degree within the United States?
- YesNo
- YesNoN/A
- Income Verification Section
  
  THIS APPLICATION REQUIRES PARENT/GUARDIAN INCOME VERIFICATION
- YesNo
- 20252024202320222021Year not listed
- If YES: What was your federal TAXABLE INCOME (Form 1040, line 15) from the most recent tax year?*
- If NO: Please provide estimated annual family income for 2024:*
- Number of people living in your household? (This should include yourself and your child)*
- Why do you want to participate in the TRiO Upward Bound Program?*
- Why do you want to go to college? *
- If you could have any job for one day, what would you pick and why?*
- Are you involved in sports, church, volunteer organizations, or other extra-curricular activities? Please Describe:*
- What is your favorite and least favorite school subject and why? *
- YesNoMaybe
- If you selected "No" or "Maybe" on the question above, please explain why:*
- I understand and am excited!
- Personal Statement:
- The personal statement is an important part of the selection process for this program. In 250-500 words, answer and discuss ONE of the following questions and either type your response into the provided box or upload a PDF/Word Document:
  
  1. Why do you want to be in the Upward Bound Program? What do you believe you will gain from the experience, and what contributions can you make to the program?
  
  2. Tell us about any activities you’re involved in, accomplishments you’re proud of, or challenges you’ve faced. What have you learned from them?
  
  3. What are your dreams for the future?
- Personal Statement*
  
  0/500
- PDF/Word document upload
  
  Cancelof
- Transcript and other Academic Records Waiver
- The Family Educational Rights and Privacy Act (FERPA) (20 U.S.C. § 1232g; 34 CFR Part 99) is a Federal law that protects the privacy of student education records. The law applies to all schools that receive funds under an applicable program of the U.S. Department of Education. These rights include the right to provide written consent before a school, university, or college discloses personally identifiable information (PII) from a student’s education records.
  
  I hereby authorize my student’s school(s) to provide Sonoma State University’s Pre-Collegiate Programs (i.e., TRiO Upward Bound Programs) access to copies of my student’s academic records and transcripts for the duration of their secondary and post-secondary education. I understand these records will be kept confidential and will be used strictly to meet federal reporting guidelines outlined by the Department of Education, to follow students’ educational progress, and to determine when extra scholastic services are needed on his/her behalf.
  
  Under penalties of perjury, I declare that I have examined this form and to the best of my knowledge and belief, the information is true, correct, and complete.
- Type Parent/Guardian Full Name:*
  
  First NameLast Name
- Parent/Guardian's Signature: *
  
  Clear
- Date:*
  
  MonthDayYear
  mm-dd-yyyy

2025-2026 New Student Application

Income Verification Section

Personal Statement:

Transcript and other Academic Records Waiver