St. Olaf Upward Bound Application



St. Olaf College TRIO Upward Bound Student 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 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 six-week residential Summer Program and participate in our Academic School Year Program, which have the following major objectives: 1. Increase 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 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.
Part One: General Information
1. First Name *
2. Middle Name
3. Last Name *
4. Date of Birth *
5. Home Phone Number
6. Student Cell Phone Number
7. School * Central High School Creative Arts Secondary Highland Park High School Humboldt High School Open World Learning Community
8. Grade * 9th Grade 10th Grade 11th Grade
9. School ID Number *
10. Street Address *
11. City *
12. State (Abbreviation) *
13. Permanent Zipcode *
14. Student School Email *
15. Student Preferred Email
Part Two: Demographic Information The information in this section is listed as it is required by the U.S. Department of Education. The St. Olaf College TRIO Upward Bound 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.
1. Gender *
2. Preferred Gender Pronouns he/him/his she/her/hers they/them/theirs other
If other, please specify:
3. Ethnic/Racial Background (Check ALL that apply):
American Indian/Alaskan Native
Asian
Black or African American
Hispanic or Latinx
White
Other, please specify:
4. Which language(s) are primarily spoken in your home? *
5. List in order language(s) you speak fluently:
First Language Learned:
Second Language Learned:
Third Language Learned:
6. 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):
Permanent Residence Card Expiration Date (if applicable):
*Please note, the Upward Bound program will require a copy of your permanent residence card (if applicable) upon acceptance to the program.
Part Three: Student Information
1. What kinds of free-time activities do you like to do with friends? *
2. In which extracurricular activities are you involved? (Please specify all that apply below):
Sports, specify:
Music, specify:
School Sponsored Clubs/Organizations, specify:
Religious organizations, specify:
Other:
3. Have you ever been in an Upward Bound program before? * Yes No
If yes, when and where did you participate?
4. How many absences do you usually have per quarter? * Less than 5 Between 5-10 More than 10
5. Please list all schools you have attended since 1st grade: *
6. Have you ever attended an alternative school (e.g. GAP, ALC, Agape)? * Yes No
If yes, when/where?
7. Have you ever attended summer school for an academic subject? * Yes No
If yes, when and which subject(s)?
8. Are you or have you been involved in any type of college preparatory program? * Yes No
If yes, which program?
9. When you finish high school, what do you intend to do? * Attend University/College Attend Community College Attend Technical/Vocational College Military Service Full-time/Part-time work Other
Please tell us more about your answer above (e.g. name of college you plan on attending, branch of military you would like to join): *
10. What are your favorite subjects? *
11. What are your least favorite subjects? *
12. What careers are you interested in pursuing? *
13. With whom have you discussed your educational/career interests? (check all that apply)
School teacher/counselor/administrator
Parent/Guardian
Friend
Program Advisor
Pastor/Clergy/Rabbi/Imam
No One
Other
Please specify:
14. Name two school academic* subject teachers who you would like to fill out St. Olaf Upward Bound 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: *
15. Are you currently employed? * Yes No
If yes, where do you work? How many hours per week?
16. How do you typically spend your time after school each day? *
17. Is there anything that may prevent you from going to and succeeding in college? *
18. Why do you want to be in Upward Bound? *
19. If admitted to Upward Bound, what are several goals you would like to accomplish and why are these goals important to you? *
20. Do you have a record with the juvenile court system? * No Yes
If yes, when/where?
Part Four: Student Family Background
1. With whom do you live? (Check all that apply)
Mother
Father
Step Mother
Step Father
Foster Parent(s)
Alone
Spouse
Group Home
Foster Home
Relative other than parent
Please specify:
Guardian or Other, not a relative
Please specify:
2. Who is/are your legal guardian(s)?
Both Parents
Mother Only
Father Only
Ward of the Court
Other legal guardian, please specify:
3. Do your parent(s)/guardian(s) check your homework? * Yes No
4. Do your parent(s)/guardian(s) attend parent/teacher conferences? * Yes No
5. Do your parent(s)/guardian(s) indicate they want you to continue your education after high school? * Yes No
6. 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 10-12th grade High school graduate or GED Some college (no degree obtained) 2 year college degree/certificate 4 year college degree Completed graduate school (M.A., Ph.D., etc.) Do not know
Parent/Guardian 1 relationship to you * Mother Father Step-Parent Guardian
Parent/Guardian 2 None 6th grade or less 7th-9th grade 10-12th grade High school graduate or GED Some college (no degree obtained) 2 year college degree/certificate 4 year college degree Completed graduate school (M.A., Ph.D., etc.) Do Not Know
Parent/Guardian 2 relationship to you Mother Father Step-Parent Gaurdian
7. 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
8. 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 Five: Student Needs Assessment *Please complete the questions below as honestly as possible. Your answers will helps us to better understand your academic needs.*
ACADEMICS
1. I need to hand in homework on a more consistent basis. Yes No
2. I need to get better grades in school. Yes No
3. I need help in math. Yes No
4. I need help in science. Yes No
5. I need help in English Yes No
6. I need help in social studies. Yes No
7. I need help in foreign language Yes No
8. I need to learn how to take better notes. Yes No
9. I need to develop stronger study habits. Yes No
10. I need to learn relaxation techniques to reduce my test anxiety. Yes No
11. I need to learn test taking strategies. Yes No
I need to learn how to manage my time so that personal, academic, and extra-curricular activities are balanced. Yes No
13. I need to learn how to read a textbook more effectively. Yes No
14. I need to develop a better attitude toward learning. Yes No
15. I need to receive guidance in selecting academic courses. Yes No
16. I need to be enrolled in more college prep courses. Yes No
17. I need to know more about high school graduation requirements. Yes No
18. I need to listen more effectively in class. Yes No
19. I need to learn how to participate in classroom discussion. Yes No
20. I need to communicate more effectively with teachers. Yes No
21. I need to have better relationships with teachers. Yes No
22. I need to know more about my strengths and weaknesses. Yes No
23. I need to understand what I can realistically achieve. Yes No
CAREERS
1. I need to know how to prepare for careers that interest me. Yes No
2. I need to know more about possible careers and the world of work. Yes No
3. I need to know how to apply and interview for jobs. Yes No
4. I need to talk to a counselor about career plans. Yes No
5. I need to have my parents involved in my career plans. Yes No
COLLEGE PLANS
1. I need to learn more about financial aid for college. Yes No
2. I need to learn more about college admission requirements. Yes No
3. I need to understand the college application process. Yes No
4. I need to decide which type of postsecondary institution to attend. Yes No
PERSONAL
1. I need to experience more cultural activities. Yes No
2. I need to become more familiar with people of other cultures. Yes No
3. I need to develop confidence in myself. Yes No
4. I need to understand how my feelings affect my behavior. Yes No
5. I need somebody to listen to me when I have problems. Yes No
6. I need to learn to tell others how I feel. Yes No
7. I need to be a better listener and respond better to others. Yes No
8. I need to build trusting relationships with others. Yes No
9. I need to become more tolerant with people whose views differ from mine. Yes No
10. I need to get along better with members of my family. Yes No
11. I need to set goals in my life. Yes No
12. I need to know how to assess and evaluate my goals. Yes No
13. I need to understand the impact of my gender and/or race on my career choices. Yes No
14. I need to accept greater responsibility for my actions. Yes No
15. I need to learn how to make decisions. 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.
Please type in your name, then provide your electronic signature: 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.

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