TRIO Upward Bound Application

When you have completed your application make sure to click on the 'submit application button'

About Upward Bound

We are happy that you are interested in joining TRIO Upward Bound!

TRIO Upward Bound is a college access and preparation program funded by the United States Department of Education and sponsored by North Dakota State University.  TRIO Upward Bound helps students succeed in high school and prepares them for continued success in the college of their choice.  Services include tutoring, academic skill development, academic advising, college entrance exam (ACT) preparation, college visits, summer program, and assistance with college and financial aid applications. 

 

Who is eligible to participate?

To be eligible, a student must, at the time of admission:

  • Be a student enrolled at Davies, Fargo North, Fargo South or Moorhead high schools (or will be enrolled in one of these schools);
  • Be at least 13 years old;
  • Have completed the 8th grade but have not yet begun 12th grade;
  • Be income-eligible OR from a family in which neither parent has graduated from a four-year college;
  • Be a United States citizen, a permanent resident, or legally in the country with intent to become a resident;
  • Have the potential and desire for academic success in high school AND post-secondary education;
  • Preference given to applicants whose cumulative GPAs are at least 2.5;
  • If applicant receives English Language Learner services, preference is given to applicants who score at least 3.5 on the ACCESS for ELLs (WIDA).

 

What is expected of TRIO Upward Bound students?

TRIO Upward Bound students must be motivated to consistently do their best academic work and be committed to attending college after graduating from high school.  Expected behaviors include:

  • Complete academic work to your best ability.The target GPA for Upward Bound students is 2.5 or higher.
  • Participate in all Upward Bound activities in the academic year including monthly meetings with an Upward Bound adviser, monthly Saturday programming, and weekly tutoring.
  • Participate in all Upward Bound activities in the six-week summer program (Monday-Friday, 8:00 a.m.-3:30 p.m.)
  • Consistently show respect for others.

 

What is expected of the parents/guardians of TRIO Upward Bound students?

  • Parents/Guardians also have an important role in students’ academic success.They are expected to:
  • Monitor student’s school attendance, homework completion, and academic performance.
  • Encourage good study habits at home.
  • Be sure student has transportation to and from Upward Bound activities.
  • Allow student to fully participate in Upward Bound activities, which may require scheduling around Upward Bound required events.

Application Instructions

  • Please fill in all sections of the below application. 
  • Make sure to click on the 'submit application' button at the bottom of the application.  
  • Once submitted, your application will be reviewed by Upward Bound staff.
  • UB staff will connect with you to set up an entrance interview.  

Student Personal Information 

In this section of the application please fill in the students applicant's personal and contact information.  
First Name
Middle Name
Last Name
Street/Apt.
City
State
Zip Code
Student's Cell Phone Number
Check if you don't have a cell phone
Ok to text?
Email (that you check frequently)
Date of Birth (MMDDYYYY)
Gender
Race (check all that apply)
African American/Black
American Indian/Native
Asian/Pacific Islander
Hispanic/Non-Black
White
Citizen (HEOA 645.3-Students must be a US Citizen, National or Permanent Resident to qualify for Upward Bound)
How many people are in your household (including the student)?

Student School and Goals Information

In this section of the application, please fill in the student applicant's school and goals information.  
High School you are or will be attending.
Grade
Graduation Year
Cumulative GPA
After I graduate from high school I plan to:
Please list 3 words that best describe you.
What are the top 3 goals you would like to accomplish in the Upward Bound program?

Student Recommendation Section 

In this section of the application, please provide Upward Bound with a counselor or teacher that can provide information about your academics and future goals.  
Teacher Counselor Name (First and Last)
Teacher or Counselor Email Address
Who referred you to the Upward Bound program?

Parent/Guardian Information 

In this section of the application, please fill out information pertaining to the student applicant's parents or guardians.  
Parent/Guardian #1
Parent/Guardian Name
Address
City
State
Zip Code
Phone
Email Address
Contact 1 Relationship
Legal Guardian
Parent/Guardian #1 Highest Education Level Completed
Does the student currently live with this person?
Parent/Guardian #2
Name
Address
City
State
Zip
Phone
Email Address
Contact 2 Relationship
Highest Education Level Completed
Does the student currently live with this person?
Legal Guardian?

Family Income Information

In this section of the application, we are verifying the parent/guardian income information. This income information is used to determine eligibility for the Upward Bound program.  We can verify family income based on your income tax return , or if you didn’t file a return we can verify based on income information you provide.

Did you file a federal income tax return last year? 

  • Yes - go to section A below
  • No - go to section B below

SECTION A - to be filled out only if you DID file a tax return last year. If you did NOT file a tax return last year, please skip this section and complete section B below.
What was your total taxable income for last tax year*?

*Where can I find my family total taxable income? Taxable income can be found on your tax return:

  • Form 1040 - Line 15
  • Form 1040A - Line 21
  • Form 1040EZ - Line 6

Provide your tax return. If you filed a tax return, we need a copy for our records. You can provide a copy by uploading it here. If you cannot upload a copy, we will make arrangements to get a copy from you.

I cannot upload a copy of my tax return.
Parent/Guardian signature. Please provide your signature electronically on this form to verify your income tax information. 
Please select a signature verification type.

SECTION B - to be filled out only if you did NOT file a tax return last year. 
I did NOT file a Federal Income Tax Return last year.
My monthly income from all employment is
I receive the following no-taxable income:  
TANF
VA Disability
Workman's Compensation
General Assistance
Financial Aid
Unemployment Compensation
Medical Assistance

Parent/Guardian signature. Please provide your signature electronically on this form to verify the income information you provided.

I, the parent/guardian of the Upward Bound student applicant, verify that the information I have provided for the Did Not File Certification (Section B) is true and accurate.

Please select a signature verification type.

Certification of Release of Records 

The personal information you give to the Upward Bound Director is sent to the Federal Government (Department of Education). The information is protected by the Privacy Act. No one may see the information unless they work with or for the Upward Bound Program or are specifically authorized to see the information. The information is necessary to determine if you are eligible to participate in the program and helps the government to measure your success. The Department of Education has authority to gather information to help make Upward Bound a better program. If you do not give this information to the Upward Bound program and the Department of Education, you cannot receive any benefits from the program.

I hereby authorize the release of the following information to the Upward Bound Program at North Dakota State University:

A) Transcript of grades from his/her school records

B) Standardized test scores

C) School counselor or psychologist information

D) School attendance records

E) Financial Aid award letters

F) AFDC and Social Security verification, JTPA family financial information

G) Free/reduced lunch verification

This information is to be used as part of the evaluation and follow-up related to the Upward Bound Program. All information is to be treated as confidential, in keeping to the Family Educational Rights and Privacy Act. This release is to be considered valid for the period of time that my son/daughter remains in the Upward Bound Program.

I fully understand the above provision and hereby give consent to have all pertinent data forwarded to the North Dakota State University Upward Bound Program for the duration of my son’s/daughter’s participation in the program
Student Full Name
Student Signature
Please select a signature verification type.
Parent/Guardian Signature
Please select a signature verification type.
School
Once you have completed your application, please click on the 'submit application' button below. Â