APPLICATION PROCESS
Interested Students and Parents Must:
1. Complete the one-page Information Sheet
2. Write and submit a one-page, typed essay explaining why education
is important and why they want to participate in Upward Bound
3. Include a copy of most recent grades and class schedule
4. Submit a Teacher recommendation form (due to the likelihood of
greater familiarity, 8th grade teachers will be accepted from 9th grade
students up through October of the current school year)
5. Verify Income- initially the student’s free/reduce lunch status will be
used to determine qualification.
6. Participate in a scheduled individual or group interview, either at the
Upward Bound office (parent must be in attendance) or as a group at
their respective schools
If accepted to the program, additional information will be needed including (but not
limited to): social security number, income verification (most recent IRS tax
information), and a recommendation from current guidance counselor.
***Students are prohibited by law from attending any Upward Bound sessions until
all necessary information has been submitted and received by Upward Bound staff
Should you have any questions, please feel free to contact:


Mr. Lessane (Director, Upward Bound and Pre-College Programs)
953.6555 and lessaneta@cofc.edu
Mr. Grimmage (Academic Counselor, Upward Bound and Pre-College Programs)
953-1860 and grimmagekc@cofc.edu
Student Information
Student Name__________________________________________________ Gender M ____ F _____
Preferred Phone Number_______________________________________________________________
Preferred e-mail address _______________________________________________________________
Name of High School Attended (or will attend in fall) ______________________________________
Student Grade________
Most Recent GPA_________
Parent Information
Parent/Guardian Name(s)________________________________________________
Permanent Address (street, city, state, zip). Please identify and list multiple addresses if Student
resides with more than one parent:
______________________________________________________________________________
______________________________________________________________________________
_____________________________________________________________________________________
_______________________________________________________________________
Preferred Phone Number (mother): __________________ (father): ___________________
Email Address_________________________________________________________________
Estimated Household Income______________
Parent/Guardian(s) Earned Bachelor’s Degree (Y/N) ______
66 George Street Charleston, SC 29424
Phone: (843) 953-5469 Fax: (843) 953-4902 Email: lessaneta@cofc.edu
COUNSELOR RECOMMENDATION FORM
Dear Teacher:
The student listed below is applying for admission into the College of Charleston Upward Bound Program. Your assessment of the
student’s conduct, character and academic need for program services is an integral element in the admission process. Please give us
your honest assessment of this student’s desire and ability to learn. Please mail the completed Recommendation Form to the above
address or fax to (843) 953-4902. You may also return the completed Recommendation Form to the student in a sealed envelope to
submit with his/her completed student application. Should you have any questions or concerns, please feel free to contact the
Upward Bound Staff at (843) 953-5469. The time and effort you have taken to complete this form is sincerely appreciated.
Student’s Name
Grade Level
School ______________________________________________________________________________
Class/Course Subject: _______________________________ Current Class/Course Grade
Please place an "x" in the appropriate column for each characteristic listed below:
STUDENT CHARACTERISTICS
EXCELLENT
AVERAGE
FAIR
CONDUCT IN CLASS
WILLINGLY PARTICIPATES IN CLASS
RESPECTS OTHERS AND THEIR PROPERTY
ABILITY TO FOLLOW INSTRUCTIONS
COMPLETES ASSIGNED WORK ON TIME
STUDY SKILLS/HABITS
ANALYTICAL THINKING SKILLS
MATURITY/INTEGRITY
PUNCTUALITY
EAGER TO LEARN NEW THINGS
DEMONSTRATES MOTIVATION TO COMPLETE A 5-WEEK SUMMER
PROGRAM
Please provide comments on motivation, behavior, personality, strengths or weaknesses that you feel are pertinent to the student’s
performance in the Upward Bound Program. Additional comments may be written on the back.
________
________
__________________________________________________________________________________________
___________________________________________________________________________________________
Teacher’s Printed Name & Title
School Telephone Number
Teacher’s Signature
Date
POOR
66 George Street Charleston, SC 29424
Phone: (843) 953-5469 Fax: (843) 953-4902 Email: lessaneta@cofc.edu
TEACHER RECOMMENDATION FORM
Dear Teacher:
The student listed below is applying for admission into the College of Charleston Upward Bound Program. Your assessment of the
student’s conduct, character and academic need for program services is an integral element in the admission process. Please give us
your honest assessment of this student’s desire and ability to learn. Please mail the completed Recommendation Form to the above
address or fax to (843) 953-4902. You may also return the completed Recommendation Form to the student in a sealed envelope to
submit with his/her completed student application. Should you have any questions or concerns, please feel free to contact the
Upward Bound Staff at (843) 953-5469. The time and effort you have taken to complete this form is sincerely appreciated.
Student’s Name
Grade Level
School ______________________________________________________________________________
Class/Course Subject: _______________________________ Current Class/Course Grade
Please place an "x" in the appropriate column for each characteristic listed below:
STUDENT CHARACTERISTICS
EXCELLENT
AVERAGE
FAIR
CONDUCT IN CLASS
WILLINGLY PARTICIPATES IN CLASS
RESPECTS OTHERS AND THEIR PROPERTY
ABILITY TO FOLLOW INSTRUCTIONS
COMPLETES ASSIGNED WORK ON TIME
STUDY SKILLS/HABITS
ANALYTICAL THINKING SKILLS
MATURITY/INTEGRITY
PUNCTUALITY
EAGER TO LEARN NEW THINGS
DEMONSTRATES MOTIVATION TO COMPLETE A 5-WEEK SUMMER
PROGRAM
Please provide comments on motivation, behavior, personality, strengths or weaknesses that you feel are pertinent to the student’s
performance in the Upward Bound Program. Additional comments may be written on the back.
________
________
__________________________________________________________________________________________
___________________________________________________________________________________________
Teacher’s Printed Name & Title
School Telephone Number
Teacher’s Signature
Date
POOR
I certify that the information provided on this form is true and complete to the best of my knowledge.
_____________________________________________ __________
Parent’s Signature
Date
Income Information:
Please attach a SIGNED copy of your current U.S. Income Tax Return Form in order to verify annual taxable income
RELEASE OF SCHOOL RECORDS
I authorize the College of Charleston Upward Bound Program to access and/or receive copies of my student’s academic
transcripts, grade reports, report cards, PASS/HSAP scores, and any other academic information and test results necessary to
complete the program’s application process.
_____________________________________________ __________
Parent’s Signature
Date
Student’s Name: ______________________________________
Social Security #: _______________________________
School: _____________________________________________
The Family Educational Rights and Privacy Act (FERPA), 20 U.S.C. §1232g, and the South Carolina Public Information Act, South
Carolina Government Code §552.001 et seq., are respectively federal and state laws providing for the review and disclosure of student
educational records. The College and Outreach Programs-TRIO and Upward Bound will not permit access to or the release of personally
identifiable information contained in student educational records to any party without the written consent of the student, except as
authorized by FERPA.=