THE UNIVERSITY OF MIAMI UPWARD BOUND SCHOLARS PROGRAM
The University of Miami Upward Bound Program is designed to assist students with academic potential who need
additional academic support and motivation to succeed in high school and later, in college. We provide an on-going
program of academic and counseling activities. Students may participate in the program from the time they are
enrolled until they graduate from high school.
Funded by the United States Department of Education Federal TRIO Program and sponsored by the University of
Miami School of Education, Upward Bound has existed on the UM’s campus since fiscal year 1967-68. The program
has provided service and has positively impacted more than 2,000 students, who have enrolled in, graduated or are
currently attending colleges and universities all over the country. Upward Bound is funded to serve ninety-four (94)
students in Miami Dade County.
ACADEMIC YEAR PROGRAM
During the academic year, a supportive instructional program in the areas of Math (Algebra I – Calculus), English,
Science, SAT (Verbal/Math), Social Studies, Foreign Language and FCAT Preparation is offered weekly on Tuesdays
and monthly Saturday Academy sessions. Tutorial assistance in theses academic subjects is provided to aid the
students in meeting the demands of their high school curriculum.
SUMMER PROGRAM
A six-week summer residential program is also offered to program participants who demonstrate their commitment
to the program during the academic year. This component of the program is designed to simulate a college-going
experience, the summer program focuses on academic, counseling, college, career and recreational activities.
Students enroll in academic classes mentioned above based on their grade level and high school curriculum. Students
may receive one elective credit for attendance and participation in these classes. Students will be provided with an
opportunity to further develop academically by enrolling in classes such as computer technology, scholars bowl,
creative writing, spelling bee and debate. Courses that appeal to student’s creative interest are also provided; they
include: journalism, drama, dance, art, chorus and computer technology. Additionally, will also enroll in
sports/recreational activities; they include: basketball, volleyball, softball, swimming, track and cheerleading.
Summer Bridge Program
As a summer bridge participant, recent program graduates may earn college credit during the summer following their
high school graduation.
Counseling
Via the counseling program, Upward Bound assists students with goal-setting, decision-making, scholarship
information, career planning, academic advising, college applications and financial aid opportunities so that the dream
of a college education can become a reality.
Eligibility
Eligibility to participate in the program is determined individually. However the criteria has been established by the U.S.
Department of Education. Students must be (1) a First-Generation college student (meaning neither parent living in
the household have earned a four-year college degree); and (2) family taxable income level must meet the established
guidelines. Students must complete an application that requires them to write an essay, submit letters of
recommendations from school counselor and teachers and submit a high school transcript.
The University of Miami Upward Bound Program is committed to assisting students with
achieving secondary and post-secondary aspirations.
For more information or to request an application contact:
University of Miami Upward Bound Program
P.O. Box 248106
Coral Gables, Florida 33124-5590
(305) 284-3015 (Phone)
(305) 284-4268 (Fax)
umub@miami.edu
www.upwardbound.org
UNIVERSITY OF MIAMI
UPWARD BOUND SCHOLARS PROGRAM
APPLICATION FOR PROGRAM PARTICIPATION
IMPORTANT
When submitting this application, be sure that the following documents have been attached: (1)
Copy of Family’s 1040 form; (2) Essay; (3) Counselor/Teacher Recommendation Forms;
(4) High School Transcript; and, (5) Record Release Form.
Date_____________________
PERSONAL INFORMATION
Name___________________________________________
Social Security __________________________
Address_____________________________________________ City__________ State_______ Zip__________
Telephone (______)___________________________________
 Yes
Are you a United States Citizen?
 No
Date of Birth______________________
Gender
 Male
 Female
IF YOU ARE A RESIDENT ALIEN, PLEASE PROVIDE YOUR RESIDENT ALIEN NUMBER AND ATTACH A
COPY OF YOUR INS CARD.____________________________________.







Ethnic Origin
African American (Non-Hispanic)
American Indian or Alaskan Native
Asian or Pacific Islander
Haitian American
Hispanic
White (Non-Hispanic)
Other (specify)_________________
EDUCATION/ACADEMIC INFORMATION
Current Grade:
9
10
11
12
Grade Point Average_____________________
High School Program
Academic/College Prep
High School____________________________________
High School Counselor ___________________________
General
Vocational
University of Miami Upward Bound Application - Page 2
PARENT/GUARDIAN INFORMATION
TO BE COMPLETED BY PARENT/GUARDIAN
Father’s Name______________________________________________ Occupation _______________________
(If guardian) Relationship to Student ______________________________________________________________
Address___________________________________________
City:_________State_________Zip___________
Home Phone (_______)______________________________
Work Phone (______)_____________________
Are you a college graduate?
Yes
No
If yes, indicate College Attended_________________________
Degree Earned ____________________
Mother’s Name_____________________________________________ Occupation _______________________
(If guardian) Relationship to Student ______________________________________________________________
Address___________________________________________
City:_________State_________Zip___________
Home Phone (_______)______________________________
Work Phone (______)_____________________
Are you a college graduate?
Yes
No
If yes, indicate College Attended_________________________
Degree Earned ____________________
INCOME INFORMATION
(Attach a copy of most recent 1040 Tax Return Form)
Family Size (Total number in household):
________________
Family Income:
Father’s /Guardian’s Income (If living in same household as student)
$_______________
Mother’s/Guardian’s Income (If living in same household as student)
$_______________
Other Income: Source__________________________________
$_______________
Family Taxable Income (From IRS 1040, 20_____)
$_______________
Tax Filing Status



Single
Head of Household


Married Filing Separate Return
Married Filing Joint Return
Qualifying Widow (er)
NOTE: If family’s income was not large enough to require filing an income tax return, a notarized statement
indicating the amount earned for the year and source of income is needed. If the family received Social Security
benefits or Welfare, a statement from the aid agency must be submitted.
I certify that the income information provided above is accurate and can be verified:
_________________________________________
Print Name
______________________________________
Signature
Date
University of Miami Upward Bound Scholars Application - Page 3
UNIVERSITY OF MIAMI UPWARD BOUND SCHOLARS PROGRAM
AUTHORIZATION TO RELEASE
HIGH SCHOOL RECORD FORM
(form expires in 2012)
Students Name (print)__________________________ School ID #_______________________
High School:_________________________________ Counselor:______________________
This form will allow the University of Miami Upward Bound Program to receive a copy of your
son/daughter’s school records. These records will be used to provide academic advisement, to
document academic progress and to confirm high school graduation for your child. They will
be handled in a confidential manner and will be made available only to program staff and
representatives from the federal and state Departments of Education.
Please be advised that I have signed the record release form below, and I have asked my
son/daughter to present it to the registrar at his/her school. This will allow the release of the
following records to the Upward Bound Program.
Grade Report/Report Card
Official High School Transcript
PSAT Scores
SSAT Scores
SAT Scores
FCAT Scores
Stanine Reading/Math Scores
Any other records, which program staff, may request
for the purposes of providing academic advisement
and assessment for my son/daughter.
Parent’s/Guardian’s Signature:_____________________________ Date:_______________
Student’s Signature:_____________________________________ Date:_______________
UM Upward Bound Application - Page 4
STUDENT DATA FORM
TO BE COMPLETED BY STUDENT
Name:_________________________________________________
1.
Provide the names of two adult individuals who we may contact as references.
Name___________________________________________
Phone_________________________
Name___________________________________________
Phone_________________________
2.
What do you plan to do after graduation from high school?
3.
List your school activities (such as sports, clubs, student government organization, band, etc.).
_______________________________
_________________________________
_______________________________
_________________________________
4.
What do you like to do in your spare time?
5.
Who has influenced you most?
Why?
6.
Do you currently have a job?
Yes
No
If yes, where?___________________________________
What days and how many hours per week do you work?________________________________________
7.
List your hobbies and talents
8.
What are your best academic subjects in school, and why
9.
What is your career choice?_______________________________________________________ ____
10.
Do you feel you need to improve your grades? Why?
UM Upward Bound Application - Page 5
ESSAY
Name:____________________________________
Social Security#:_____________________________
I WANT TO GO TO COLLEGE BECAUSE:
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
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UM Upward Bound Application - Page 6
EMERGENCY CONTACT INFORMATION
In case of emergency and parents/guardians can not be contacted.
Name_______________________________________________
Relationship_______________________
Address_____________________________________________
Home Phone ______________________
Work Phone_______________________
Name_______________________________________________
Relationship_______________________
Address_____________________________________________
Home Phone ______________________
Work Phone_______________________
Name_______________________________________________
Relationship_______________________
Address_____________________________________________
Home Phone ______________________
Work
Phone_______________________
TRANSPORTATION AUTHORIZATION
I authorize the University of Miami Upward Bound Program to provide transportation for my son/daughter
to attend scheduled program activities.
______________________________________________
Parent’s Signature
Date
Upward Bound Scholars Program at the University of Miami
P.O. Box 248106
Coral Gables, Florida 331245590
(305) 284-3015
COUNSELOR RECOMMENDATION FORM
TO BE COMPLETED BY HIGH SCHOOL COUNSELOR
Student:_________________________________________
Current Grade:___________________________
The aforementioned student is applying for participation in the University of Miami Upward Bound Scholars
Program. Please complete this form and either return it to the student or forward directly to the Upward Bound
Office at the above address. Your cooperation is appreciated.
Which of the following best describes the student’s high school curriculum?
Vocational General
Academic/College-Prep
Honors
Remedial
Other_____________________________________________________________________________________
What is the student’s Grade Point Average?____________________
10%
Approximate rank?
25%
50%
What is the student’s reading level?_______________________________________________________________
(Above, At or Below Grade Level)
How would you describe the student’s attendance?
Excellent
Good
Fair
Poor
Would you classify this student as having potential for post-secondary education?
Yes
No
If no, please explain:___________________________________________________________________________
Would the student need and/or benefit from tutorial and counseling assistance?____________________________
___________________________________________________________________________________________
Please comment on any personal or social difficulties that this student is known to have or have had which might
be cause for concern in a residential program such as Upward Bound.
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
Counselor’s Signature__________________________________________
Date:_____________________
Counselor’s Name (Print)_______________________________________
High School:_________________________________________________
Upward Bound Scholars Program at the University of Miami
P.O. Box 248106
Coral Gables, Florida 331245590
(305) 284-3015
TEACHER RECOMMENDATION FORM
TO BE COMPLETED BY ENGLISH TEACHER
Student:________________________________________
Current Academic Grade:_____________
(A – F)
Course Title:____________________________________
The aforementioned student is applying for participation in the University of Miami Upward Bound Scholars Program.
Please complete this form and either return it to the student or forward directly to the Upward Bound Office at the above
address. Your cooperation is appreciated. Please comment on this student’s ability/skills and deficiencies in each of the
following areas.
11.
Written Communication:
12.
Oral Communication:
13.
Study Skills:
Would you say that this student has potential for post-secondary education?
Please indicate areas in which you feel Upward Bound can assist the student in a tutorial setting?
Please comment on your perception of the student’s maturity, cooperativeness, reliability, discipline, and motivation to
succeed academically?
Teacher’s Signature:___________________________________________
High School:
Date:
Upward Bound Scholars Program at the University of Miami
P.O. Box 248106
Coral Gables, Florida 331245590
(305) 284-3015
TEACHER RECOMMENDATION FORM
TO BE COMPLETED BY SCIENCE TEACHER
Student:________________________________________
Current Academic Grade:_____________
(A – F)
Course Title:____________________________________
The aforementioned student is applying for participation in the University of Miami Upward Bound scholars Program.
Please complete this form and either return it to the student or forward directly to the Upward Bound Office at the above
address. Your cooperation is appreciated. Please comment on this student’s ability/skills and deficiencies in each of the
following areas.
14.
Ability to relate basic science skills to practical applications:
15.
Knowledge of an ability to organize fundamental science concepts:
16.
Possession of research skills and ability to utilize resource materials:
Does this student possess verbal written communication skills?
Does this student have college level potential in any field of science?
How can this student benefit from a science tutorial setting?
Teacher’s Signature: ___________________________________________Date:
High School:
Upward Bound Scholars Program at the University of Miami
P.O. Box 248106
Coral Gables, Florida 331245590
(305) 284-3015
TEACHER RECOMMENDATION FORM
TO BE COMPLETED BY MATH TEACHER
Student:________________________________________
Current Academic Grade:_____________
(A –
F)
Course Title:____________________________________
The aforementioned student is applying for participation in the University of Miami Upward Bound Scholars
Program. Please complete this form and either return it to the student or forward directly to the Upward Bound
Office at the above address. Your cooperation is appreciated. Please comment on this student’s ability/skills and
deficiencies in each of the following areas.
17.
Knowledge of fundamental math:
18.
Ability to relate basic math skills to practical application:
19.
Knowledge of elementary algebraic functions:
Study habits and techniques:
Would you say that this student has potential for higher level math?
If yes, what level?
Why?
Would you say that this student has potential for post-secondary education?
Please indicate areas in which you feel Upward Bound can assist this student in a tutorial setting?
Please comment on your perception of the student’s maturity, cooperativeness, reliability, discipline and
motivation to succeed academically:
Teacher’s Signature:
Date:
High School:
Upward Bound Scholars Program at the University of Miami
P.O. Box 248106
Coral Gables, Florida 331245590
(305) 284-3015
TEACHER RECOMMENDATION FORM
TO BE COMPLETED BY SOCIAL STUDIES TEACHER
Student:________________________________________
Current Academic Grade:_____________
(A – F)
Course Title:____________________________________
The aforementioned student is applying for participation in the University of Miami Upward Bound Scholars
Program. Please complete this form and either return it to the student or forward directly to the Upward Bound
Office at the above address. Your cooperation is appreciated. Please comment on this student’s ability/skills and
deficiencies in each of the following areas.
20.
Does the student organize large idea units well?
21.
Does the student employ logical reasoning in presenting ideas?
22.
Does the student use resource materials effectively?
Would you say that this student has potential for post-secondary education?
Please indicate areas in which you feel Upward Bound can assist the student in a tutorial setting?
Please comment on your perception of the student’s maturity, cooperativeness, reliability, discipline and motivation
to succeed academically:
Teacher’s Signature:___________________________________________
High School:_________________________________________________
Date:______________________