Community College of Philadelphia TRIO Upward Bound Program Application

Student Information
Date of Birth *
** This information is not used to determine your eligibility for the program **
Parent/Guardian 1 Information
Parent/Guardian 2 Information
Eligibility Form and Income Verification for Parents and/or Guardians

According to the United States Department of Education, in order to be eligible for TRIO Upward Bound participation a student must be from a low-income household OR a family where neither parent has a 4-year Bachelor’s degree OR be at academic risk for failure.

The information that is requested in this application will be treated in a confidential manner. This portion of the application must be completed by a Parent/Guardian.

Household Income Information
For income verification, please include a copy of either if available • Parent/guardian’s most recent 1040 tax form, • Proof of public assistance (access card), • Proof of social security, or • Other benefits
Parent's Educational Attainment Information

Please check what best describes your educational background

I declare that the information provided on this application reflects my true family size, income level and parent/guardian’s educational background.

CCP COVID-19 Vaccination Policy
Due to the City of Philadelphia mandate, beginning Oct. 15, 2021, all students, faculty, and staff must be fully vaccinated against Covid-19 to enter Community College of Philadelphia facilities, unless they have been approved for a valid exemption. This includes all students participating in the TRIO Upward Bound program.

Once accepted into the program, all students will need to upload their vaccination card to our secure site. Anyone seeking a medical or religious exemption must complete a vaccine exemption form. Students with an approved exemption will be subject to regular on-site COVID-19 testing, as outlined by the City of Philadelphia mandate.

Anyone who visits campus must swipe their ID card at a Security desk. If a person's proof of vaccination or exemption is found in the database, the individual may enter campus. Students, faculty and staff without a valid exemption or who are not fully vaccinated against Covid-19 will not be permitted on campus.
I have read and understand the Community College of Philadelphia’s Covid-19 Vaccination Policy. *