Student/Participant Application

Please note:

Student must be willing to participate before submitting application, complete application with their information, and sign at the end to verify all information is accurate.

Parent/Guardian must provide family information and sign at the end of the application to verify all information is accurate.

Antes de enviar la solicitud, es importante que el estudiante este interesado y dispuesto a dedicarse al programa. Completa la solicitud y firma al final para verificar que toda la información esta correcta.

El padre/tutor debe proporcionar información familiar y firmar al final de la solicitud para verificar que toda la información sea precisa.

General Information: completed by student

Last Name *

Middle Name

First Name *

Preferred Name

Pronoun (he, she, they, ella, el, etc.) *

Date of Birth *

Citizenship Status *

Address 1 *

Address 2

City *

State *

Zip *

Home Phone *

Student Cell Phone Number *

Student Email (WHS Email Address) *

Personal Email *

Which language(s) are spoken at home? *

How did you hear about TRIO UB? *

How can TRIO UB help you be successful? *

Describe your primary reason for applying *

Academic Info: completed by student

Current Grade Level *

Have you taken any concurrent enrollment or IB classes?

Do you plan on taking any advanced courses? (IB or Concurrent Enrollment) *

Do you plan on taking a College Entrance Exam this year?

If Yes, which one?

Are you interested in attending college? *

If so what type of college?

Current GPA *

Family Information: completed by parent/guardian

Parent Education Level: What is highest level of education completed for natural or adoptive parent(s)/guardian(s)? *

Family Size (How many people live in your home including yourself) *

Family Taxable Income Range: Please select family’s taxable income in 2022 *

Previous Year 1040 Form

Do you receive Free or Reduced Lunch? *

By signing this application, I (we) certify that all information on this application is true and complete to the best of my knowledge. I (we) certify that the applicant currently attends Westminster High School and is a US Citizen, Permanent Resident or has intent to become a Permanent Resident. I authorize the release of the student applicant’s academic records to the Front Range Community College TRIO Upward Bound Program. The information in these records is used to assess the student applicant’s eligibility and need for services, determine student’s educational progress, evaluate program effectiveness and fulfill reporting requirements. If requested, I (we) agree to provide further documentation to verify the information reported.

Sign and Submit:

Parent/Guardian Email # 1 *

Cell Phone Parent # 1 *

Parent/Guardian Email # 2

Cell Phone Parent # 2

Primary Parent Name *

Parent/Guardian Signature *

Please select a signature verification type.

Student/Applicant Signature *

Please select a signature verification type.