Student Profile

Please answer the following questions, using your keyboard, to type in the spaces provided below.

1. Why do you want to participate in the Morehouse College Greater Orlando Upward Bound Math/Science Program? What do you expect to learn or gain from your participation and what will you contribute?*

2. What are your plans following graduation from high school? What careers are you interested in pursuing?*

3. In your opinion, what is the most significant mathematical or scientific development that affects everyday living?*

4. What are your favorite and least favorite courses and why?*

5. What is your major strength and what weaknesses would you like assistance with?*

6. Have you made any commitments that would prevent participation in the Upward Bound Math/Science State center program?*

Income Verification

In order to officially admit a student to a TRIO Program at Morehouse College, a parent(s) or legal guardian(s) must submit income verification. We must receive ONE of the following income verifications:

a copy of the current 1040, 1040A, or 1040EZ income tax forms (W-2 not acceptable)
a copy of your benefits letter from the Department of Family and Children Services
a copy of your unemployment benefits
a copy of your Social Security benefits
a copy of your Veterans benefits
a signed income statement from the student's parent or legal guardian
a letter from the current school the student attends indicating that they receive free or reduced lunch
Free Application for Federal Student Aid (FAFSA) Student Aid Report

Please upload your income verification here. Select choose file to continue.*

No File Chosen

File uploads may not work on some mobile devices.

Your application is not complete until you have submitted income verification. If you are not able to upload your income verification here, you can fax your income verification. Be sure to put your name and contact number on each sheer of paper. Fax number: (404) 588-2215

Recommendations

Please submit your counselor's and teacher's e-mail addresses for your recommendations. An e-mail will be sent directly to your counselor and teacher to complete your recommendation online.

Counselor's Name*

First Name

Last Name

Counselor's Email*

Confirm Counselor's Email *

Teacher's Name*

First Name

Last Name

Teacher's Email*

Confirm Teacher's Email *

Signature Authorization

I authorize Morehouse College Federal TRIO Programs to obtain copies of my child's transcript, test scores, and IEP’s. I permit the TRIO Program staff to release confidential information to postsecondary institutions for educational planning purposes. I also permit the Morehouse College Upward Bound Math/Science to pertain information to my post-secondary matriculation. I authorize use or disclosure of protected health information, including, but not limited to complete health records during the duration of the grant cycle and shall be in force and effect. This medical information may be used by the program personnel to receive this information for medical treatment or consultation.*

I agree

I certify that all information provided in this application is accurate. I understand that falsifying information will result in immediate rejection of this application.*

I agree I do not agree

Student Signature*

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Use your mouse or finger to draw your signature above

Parent Signature*

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Use your mouse or finger to draw your signature above

PRIVACY ACT

I understand that the information concerning me, my spouse, and child as a client will be kept in confidence and will not be revealed to anyone except TRIO Programs personnel in accordance with the Family Educational Rights and Privacy Acts.

I certify that all information provided in this application is accurate. I understand that falsifying information will result in immediate rejection of this application.

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