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.