St. Olaf Upward Bound Application



Dear Student Applicant: Before completing the attached application, please take time to read and understand the information in this letter. The material below will help you determine if you wish to apply to participate in the St. Olaf Upward Bound program. The major goal of the Upward Bound program is to help students develop the skills and motivation required to succeed in education both in high school and beyond. Admission to the Upward Bound program is not automatic; students must successfully complete a rigorous application and selection process. Upward Bound (UB) is a federally funded TRIO program designed to assist students who are interested in enhancing their academic skills and furthering their education. St. Olaf College UB students are recruited from five St. Paul high schools: Central High School, Creative Arts Secondary, Highland Park High School, Humboldt High School, and Open World Learning Community. Admitted students must take all activities required by the program seriously. If UB does not feel the student is making the necessary commitment to their education, the student may be placed on a performance contract, which, if not fulfilled, may result in dismissal from the program.
Students who are admitted must agree to take part in UB’s intensive five-week residential Summer Program (with an opportunity to attend an end-of-the summer bonus trip) and participate in our Academic School Year Program, which has the following major objectives: 1. Increase the academic performance of program participants. 2. Increase the motivation of program participants to succeed in high school and attend college. 3. Provide informative and enriching mentoring/career/educational opportunities for all participants. 4. Increase participation in cultural/educational experiences beyond those available at their high schools. 5. Provide group/individualized tutoring, guidance, and counseling for program participants. 6. Provide assistance in securing admission to a postsecondary institution and adequate financial aid to attend. 7. Provide a bridge between high school and college during the summer after the participant’s senior year. These objectives can only be met if students actively participate and accept responsibility for participation. Please feel free to contact me if you need further information or assistance. Please note: you must complete the entire student application in one sitting within 10-15 minutes. You will not be able to save your progress to return. Upward Bound is funded by the U.S. Department of Education and St. Olaf College. St. Olaf College UB is an equal opportunity employer and educator.
Part One: General Information The following requested information in this section is listed as it is required by the U.S. Department of Education. The St. Olaf College TRIO Upward Bound (UB) program recognizes that some of the identifiers in the required fields below may not accurately describe a student's demographic information. Please feel free to discuss any clarifications needed with a UB staff member.
First Name *
Middle Name
Last Name *
Date of Birth *
Home Phone Number
Student Cell Phone Number
School * Central High School Creative Arts Secondary School Highland Park High School Humboldt High School Open World Learning Community
Grade * 9th Grade 10th Grade 11th Grade
School ID Number *
Street Address *
City *
State (Abbreviation) *
Zip Code *
Student School Email *
Student Preferred Email
Gender *
Preferred Gender Pronouns He/Him/His She/Her/Hers They/Them/Theirs Other Do Not Wish To Answer
If other, please specify:
Ethnic/Racial Background (Check ALL that apply):
American Indian/Alaskan Native
Asian
Black or African American
Hispanic or Latino
White
Native Hawaiian or other Pacific Islander
Other, please specify:
Tribe or Country of Origin:
Which language(s) are primarily spoken in your home? *
List in order language(s) you speak fluently:
First Language Learned:
Second Language Learned:
Third Language Learned:
Do you have a record with the juvenile court system? * Yes No
*If yes, when/where?
Are you a United States citizen? * Yes No
*Please note, Upward Bound will require the student's social security number upon acceptance to the program.
If no, are you a Permanent U.S. Resident? Yes No
Permanent Resident USCIS Number (i.e., 00-001-001):
*If you are a Permanent U.S. Resident, you must attach a copy of your Permanent Resident Card, Form I-551 to this application.
Upload a copy of your Permanent Resident Card Here:
What kinds of free-time activities do you like to do with friends? *
In what extracurricular activities are you involved? (Examples: Sports, Music, Clubs/Orgs and etc.) *
How did you hear about Upward Bound? *
Have you ever been in an Upward Bound program before? * Yes No
If yes, when and where did you participate?
Is there anything that may prevent you from going to and succeeding in college? *
Why do you want to be in Upward Bound? *
If admitted to Upward Bound, what are several goals you would like to accomplish and why are these goals important to you? *
Part Two: Educational Background/Career Plans
Please list all schools you have attended since 1st grade: (School and Grade(s) attended) *
Have you ever attended an alternative school (e.g., GAP, ALC, Agape)? * Yes No
If yes, where/when?
Have you ever attended summer school for an academic subject? * Yes No
If yes, when and which subject(s)?
Are you or have you been involved in any type of college preparatory program? * Yes No
If yes, which program?
When you finish high school, what do you intend to do? (Example: Attend University/College, Attend Community College, Attend Technical/Vocational College, Join Military, Full-time/Part-time Work) *
What are your favorite subjects? *
What are your least favorite subjects? *
What careers are you interested in pursuing? *
With whom have you discussed your educational/career interests? *
Name two school academic* subject teachers whom you would like to fill out St. Olaf UB nominations for you. (*Nominator must teach either English, Math, Science, Social Studies, or Foreign Language).
Teacher 1 - Name and subject: *
Teacher 2 - Name and subject: *
Are you currently employed? * Yes No
If yes, where do you work? How many hours per week?
Are you able to attend a six-week residential summer program at St. Olaf College for 4 consecutive summers? * Yes No
Are you able to attend weekly after-school tutoring sessions? * Yes No
Please list your current after-school activities/work commitments if applicable:
Part Three: Student Family Background
With whom do you live? (Example: Mother, Father, Step Parent, Alone, Ward of the State, Relative, & etc.) *
Who is/are your legal guardian(s)? (Example: Both Parents, Mother only, Father only, Ward of Court, or Other, then specify who.) *
Do your parent(s)/guardian(s) check your homework? * Yes No
Do your parent(s)/guardian(s) attend parent/teacher conferences? * Yes No
Do your parent(s)/guardian(s) indicate they want you to continue your education after high school? * Yes No
Select the highest level of education completed by each of your parent(s)/guardian(s).
Parent/Guardian 1 None 6th grade or less 7th-9th grade 10th-12th grade High school graduate or GED Some college (no degree obtained) 2-year college degree/certificate 4-year college degree Graduate school (M.A., Ph.D., etc.) Do Not Know
Parent/Guardian 1 relationship to you
Parent/Guardian 2 None 6th grade or less 7th-9th grade 10th-12th grade High school graduate or GED Some college (no degree obtained) 2-year college degree/certificate 4-year college degree Graduate school (M.A., Ph.D., etc.) Do Not Know
Parent/Guardian 2 relationship to you
How many siblings do you have?
Siblings: 0 1 2 3 4 5 6 7 8 9 10 11 12
How many, if any, of your siblings have participated in Upward Bound?
Siblings: 0 1 2 3 4 5 6 7 8 9 10 11 12
Have any of your siblings had any postsecondary education? Yes No
If yes, which type of institution have they attended?
Community College
Vocational/Technical College
University/4-year college
If yes, are they currently attending, or have they completed their postsecondary education?
Currently Attending
Completed postsecondary
Part Four: Student Needs Survey
Academics
Do you need support improving your academic performance in specific subjects or overall grade? * Yes No
Would you benefit from learning better study strategies, note-taking, and time management skills? * Yes No
Do you experience challenges with test-taking or anxiety during exams, and need support managing it? * Yes No
Would you like help with goal setting, course planning, or understanding graduation and college prep requirements? * Yes No
Do you want to improve your communication and relationships with teachers or participation in class? * Yes No
Careers
Do you need help exploring career options and understanding how to prepare for them? * Yes No
Would you like support with job applications and interviewing skills? * Yes No
College Plans
Do you need help understanding how to apply to college and meet admission requirements? * Yes No
Would you like support exploring college options and learning about financial aid? * Yes No
Personal
Would you like to build more confidence, emotional awareness, and personal responsibility? * Yes No
Do you need someone to talk to and help you work through personal or emotional challenges? * Yes No
Would you like support developing better communication and relationships with others? * Yes No
Are you interested in exploring cultural experiences and understanding how identity may shape your opportunities? * Yes No
I certify that all information provided on this form is valid and correct. I understand that admission to St. Olaf TRIO Upward Bound is not automatic, and that if admitted, I will be informed of all program goals, objectives, and requirements. This includes annual participation in a six-week summer program. I also understand that failure to meet program requirements, goals, and objectives may result in my termination from the program.
* Signature Type: Simple Start Over Reset Signature Pad Click here to start signing. Tool Dialog Close Pencil Reset Signature: (Type in your full name) I agree to the terms included.