UPWARD BOUND MATH SCIENCE (UBMS) provides fundamental resources and support for college entrance, focusing on strengthening the math and science skills of our participants. Our program enables participants to successfully complete high school and engage in college coursework. The program currently serves Gainesville and Newberry High Schools. The goal of this program is to help students recognize and potentially excel in math and science career tracks while encouraging all students to pursue postsecondary degrees.

First Name *
Last Name *
Social Security Number *
Local Address *
School Name *
Student Phone *
Student Email Address
Gender *
US Citizen *
Ethnicity *
Race *
Current Grade *
Unweighted GPA *
Parent/Guardian 1 Name *
Parent/ Guardian Home Phone *
Parent/ Guardian Email Address *
Parent Occupation *
Parent Employer
Work Phone
Parent Education Level *
Parent/ Guardian 2 Name
Parent/ Guardian 2 Home Phone
Parent/Guardian 2 Email Address
Parent/ Guardian 2 Occupation
Parent/ Guardian 2 Employer
Parent/ Guardian 2 Educational Level

STUDENT PERSONAL DATA:

To be completed by the student. 
Why do you want to increase your skills in math and science? *
What are your future educational goals? *
What accomplishments are you most proud of and why? *
My best subjects in school are: *
Academically, I feel I need additional help in the following subjects: *
I am interested in attending the following colleges: *
What are your extracurricular activities ? *

STATEMENT OF INCOME 

Eligibility for Upward Bound is based on the income of your family (whether your income meets federal guidelines is a factor of your wages earned and the number of persons in your family) and educational attainment. Please respond to the following questions:
Family Taxable Income (See IRS Forms: Line 15 of the 1040 tax form.) Note: This different than the gross income. Taxable income is usually lower. *
Number of people in family: *
Did your family receive Temporary Assistance for Needy Families (TANF) last 2 years? *
Did your family receive any public assistance in the last 2 years? *

Teacher Recommendation 

Please make sure your teacher's email is correct. Recommendation forms will be sent directly to your teacher. 

 
Teacher Name *
Teacher Email Address *

Statement of Participation

(To be completed by student) 

In one paragraph, state why you want to be apart of the UBMS program and how it will benefit your future goals. 
Paragraph Essay *

Sign and Submit 
Student Signature *
Signature Type: Simple    Start Over
Signature: (Type in your full name)
I agree to the terms included.
Parent/Guardian Signature *
Signature Type: Simple    Start Over
Signature: (Type in your full name)
I agree to the terms included.