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Thank you for your interest in Whatcom Community College's Upward Bound program!  Please complete this application as thoroughly as possible.  You cannot save and restart this application.  You may want to review the included items, take some time to make notes and gather the required documents, and then return to submit your application.  If you have any questions, please email upwardbound@whatcom.edu
NOTE: The personal information you give to the TRIO Upward Bound Director is provided to the U.S. Dept. of Education. The information is protected by the Privacy Act. No one may see the information unless they work with or for the Upward Bound Program or are specifically authorized to see the information. This information is necessary to determine if you are eligible to participate in the program. If you do not give this information to the Upward Bound Program and the Dept. of Education, you cannot receive any benefits from the program
Student Last Name *
Student First Name *
Student Middle Name *
Student Date of Birth *
Address 1 *
Address 2 *
City *
State *
Zip *
Student Ethnicity *
U.S. citizen or Permanent Resident *
Home Language *
Home Phone *
Student Cell Phone *
Student Email Address *
Pronouns *
Current Grade Level *
Current School Attending *
Parent / Guardian 1 Information:
Full Name *
Address *
Parent Cell Phone Number *
Parent Work Phone Number *
Relationship to Student *
Parent Email Address *
Parent Educational Level *
Taxable Income- (Line 15 from tax form 1040) *
Most Recent IRS 1040 (Optional)
How many people in your household? *
Parent / Guardian 2 Information: (optional)
Parent 2 Full Name
Parent 2 Address
Parent 2 Cell Phone Number
Parent 2 Email Address
Parent 2 Educational Level
Parent 2 Taxable Income- (Line 15 from tax form 1040)
How many people in your household?
References:

Please list contact information for two different references. References can include; teachers, counselors, school staff, coaches, supervisors... 
Reference Name, Role, and Contact Information *
Reference Name, Role, and Contact Information *
Sign and Submit:
Student Signature *
Signature Type: Simple    Start Over
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Signature: (Type in your full name)
I agree to the terms included.
Parent Signature *
Signature Type: Simple    Start Over
Click here to start signing.
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  • Reset
Signature: (Type in your full name)
I agree to the terms included.