TRiO Upward Bound Application

College Now                                                Upward Bound
Student Information














Parent/Guardian Information




Address






Application Questions






(Check all that apply)

Essay Questions


Dear Applicant/Parent:

 

Upward Bound is a college access program of rigorous academic instruction, tutoring and advising. The program provides high school students with the opportunity to enhance the academic skills necessary to successfully complete high school and enter college upon graduation.

 

Upward Bound is funded by the U.S. Department of Education. Participants must be low-income and/or prospective first-generation college students. A prospective first-generation college student is one whose parents have not received a bachelor’s degree. In accordance with the U.S. Department of Education guidelines, a signed statement of family income must accompany this application in order for the student to be considered for the program (page 5).

 

The Academic year component of the program is a nine-month component that meets frequently throughout the school year. This component is designed to provide additional academic support services, (tutoring, course selection, college visits) that help students succeed during the school year. Students also receive assistance in preparing applications for standardized tests (ACT and SAT), college admission, and financial aid and scholarships.

 

The Summer component is a six-week, full-day program held at a local university during which Upward Bound will provide academic instruction, ACT preparation, tutoring, and individual advising. Cultural and recreational activities are also provided during the summer sessions. Students receive bus tickets and a bi-weekly stipend (check) for regular attendance and participation.

 

Participation in Upward Bound is FREE. All summer program costs are paid by Upward Bound. However, students selected to participate must have the drive, determination, and commitment to take responsibility for their educational needs by participating fully in all activities and events.

 

NOTICE OF NONDISCRIMINATION:

It is the policy of College Now Greater Cleveland that there shall be no discrimination against any individual in educational or employment opportunities because of race, color, religion, national origin, sex, veteran status, sexual orientation, or disability. Also, there shall be no discrimination because of age except in compliance with requirements of retirement plans or state and federal laws/guidelines. Any person having inquiries concerning College Now’s compliance with these regulations is directed to contact College Now below.

 

 

STATEMENT OF CONFIDENTIALITY:

The personal information that you provide to College Now Greater Cleveland is protected by the Privacy Act. No one may see the information unless he or she works with the program or is specifically authorized by the applicant’s parents/guardians. All information that parents/guardians, school counselors/teachers, and other agencies provide is necessary to determine admission to the program. If you do not give this information to Upward Bound, your application will be considered incomplete and you cannot receive the benefits of participation.

 

If you would like more information contact:

 

College Now Greater Cleveland

Upward Bound Program

1500 W. 3rd Street, Suite 125

Cleveland, Ohio 44113

www.collegenowgc.org

216.241.5587


Parent/Guardian Consent
I hereby grant permission for my son/daughter

to participate in the College Now Greater Cleveland Upward Bound Program. I am in full agreement with the mission and goals of the program and will encourage and motivate him/her to take advantage of the opportunities and benefits offered during the academic year and summer component of the program.

 

I will ensure that my son/daughter abides by the rules and regulations set forth by the program staff and accept responsibility for my son/daughter’s conduct while participating in the College Now Greater Cleveland Upward Bound Program realizing that staff is committed to the safety and welfare of my son/daughter as long as said participant is following the rules and regulations set forth by the program and that violations of provisions in the Student Contract will result in suspension and/or immediate dismissal. Along with my son/daughter adhering to the program regulations, I will participate to the best of my ability in all parent meetings and expectations outlined in the Parent Contract.

 

Furthermore, I understand that my son/daughter will be required to participate in a Summer Program at a local university and bus tickets will be provided by the College Now Upward Bound Program. I am also fully aware that during my son/daughter’s participation in the program, they will be required to participate in the following workshops:

·         After School Tutoring

·         Financial Aid/Scholarship Seminars          

·         Diagnostic Testing (COMPASS, practice ACT, etc…)

·         Summer Program

·         Community Service

·         College Field Trips

 

I understand that I am welcome at all times outside of scheduled meetings, orientations, and seminars to visit the College Now office at Parma Senior High School or the Resource Center (Post Office Plaza attached to Tower City Center) in order to become acclimated with the environment, inspect grounds and facilities, observe program activities, and meet with the Program Manager and/or other staff members.

 

Parent/Guardian Please Note: All transportation carriers’ drivers – independent contractors or College Now transportation services – contracted for field trips/activities with the Upward Bound Program are certified/licensed to operate motor vehicles

Transcript Release
I,
hereby consent to the release of my son/daughter,
high school records (transcripts, report cards, test scores, progress reports, recommendations, disciplinary records, and all other documents related to his/her academic progress/performance) to the College Now Upward Bound Program. This release is effective throughout his/her high school career and includes the final transcript upon graduation.
Parent/Guardian Income Statement
(ALL INFORMATION WILL BE KEPT STRICTLY CONFIDENTIAL)

College Now Greater Cleveland provides college visits, cultural trips, resources for tutoring, and other services to help your student graduate from high school and enroll in college. But we need you to help us!!  In order to determine if we can provide these resources, we need the following information from you: 
 
In order to determine if we can do this, we need the following information from you:






This information is accurate to the best of my knowledge and I am willing to give additional information if needed. I/we authorize College Now Greater Cleveland to obtain school records that may be necessary to provide the services essential for my child’s development.
Student Release
I,
grant College Now Greater Cleveland, Inc. (“College Now”) permission in perpetuity to use my name, photograph and likeness in any promotional, reference, research, or official business materials produced by College Now, including, without limitation, in any photographs, books, videotapes, films, or Internet websites, produced by College Now.  I also grant College Now permission to publish the results of any evaluations or surveys that I may be requested to participate in during my relationship with College Now.  I acknowledge that I may be interviewed by other media organizations regarding my participation in the programs at College Now, and if I am, I grant those organizations or individuals and College Now permission to publish such interviews.  I acknowledge that I will not have the power to approve the finished product of any media releases or interviews and I release and discharge College Now from any and all claims, including, without limitation, copyright claims, libel claims, or right of publicity claims, arising out of or in connection with the uses set forth above.


Parent Release
I am the parent or guardian of the above-named student (“my child”).  I am over the age of 18 and I have read the above paragraph.  In consideration of the benefits that my child and I receive from College Now, I am pleased to give my child’s name, photograph, and likeness to be used in the manner set forth above. I acknowledge that neither I nor my child will be compensated.  I acknowledge that I will not have the power to approve the finished product and I release and discharge College Now, any licenses and assigns of College Now, and any persons or firms that produced or worked with College Now, from any and all claims, including without limitation, copyright claims, or right of publicity claims, arising out of or in connection with the uses set forth in this Media Release.


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