Thank you for your interest in the Upward Bound Math & Science (UBMS) Program at Los Angeles Valley College.

Upward Bound Math & Science is a federally funded TRIO program sponsored by Los Angeles Valley College and supported by the U.S. Department of Education. The program is designed to support high school students in achieving academic success and preparing for enrollment in a post-secondary institution of their choice.

Eligibility Requirements
Applicants must meet the following criteria:

Be a U.S. Citizen or Permanent Resident
Be a First-Generation College Student (neither parent has earned a bachelor's degree or higher)
Meet Federal TRiO Low-Income Guidelines based on family’s taxable income
Attend one of the following high schools:

Grant High School
Robert Fulton College Preparatory School

Important Application Information

Once you begin the application, you will not be able to save your progress. Please ensure you have all the required information ready before starting.
Additional financial documentation will be required for eligibility verification.

Need Help with Your Application?
Assistance is available! If you have any questions or need help completing your application, please contact UBMS UpwardBound@lavc.edu.

Section A: Student Information

First Name *

Last Name

Middle Name

DOB *

Student Legal Status *

Gender *

Street Address *

Apt # *

City *

State *

Zip Code *

Student Cell Phone *

Student Email Address *

Do you have a disability? *

If yes, please provide further details:

Student lives with: *

Have you ever been in Foster Care? *

Ethnicity: (This information will be used for reporting purposes only) *

If Other/Multiracial, please specify:

What languages are spoken at home? *

Section B: Academics & Interest

High School Currently Attending or Will Attend: *

What is your current grade level? *

Entry GPA *

Have you ever been a participant of: *

List activities outside of school in which you participate: *

Do you have an after school job?

If yes, how many hours do you work per week?

Do you plan to attend college? *

If Other, please specify:

Are you interested in a STEM related field? (Science, Technology, Engineering, Math) *

What career/s or majors interest you: *

*

Do you understand that the LAVC TRiO Upward Bound program is a commitment from the time you are admitted all the way until you graduate from high school? *

gree to attend MANDATORY tutoring (online via Zoom) after school if you have D's or F's in your classes? *

Do you agree to attend our 6-week summer classes at LAVC? *

Will you attend MANDATORY Saturday Academy classes upon invitation? (On Saturdays, we have SAT Prep, College app assistance, Financial Aid app assistance, personal statements, and non-credited enrichment classes) *

Will you attend workshops upon invitation? (A-G workshops, Junior Timeline, FAFSA, Career Exploration, Senior Night, Study skills, summer and fall orientation) *

STUDENT - I certify that my responses on this form are accurate and complete to the best of my knowledge and that any misrepresentation may be cause for denial or cancellation of admission. I understand that I may be requested to provide income documentation. STUDENT - I understand that this ELECTRONIC SIGNATURE is a legal representation of my signature. *

Signature Type: Simple Start Over

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Signature: (Type in your full name)

I agree to the terms included.

Section C: Parent/Guardian Information

Mother/Guardian Name and Last Name

Mother/Guardian Cell Number

Mother/Guardian Email Address

Mother/Guardian's Occupation/Job Title

What was the highest level of your Mother/Guardian's education in the United States?

Father/Guardian Name and Last Name

Father/Guardian Cell Number

Father/Guardian Email Address

Father/Guardian's Occupation/Job Title

What was the highest level of your father/guardian's education in the United States?

Section D: Financial Aid Information

Note to parents/guardians: The U.S. Department of Education requires that the following information be provided for all participants prior to admission into the program. Answer all questions as thoroughly as you can.

All information submitted is kept confidential. A copy of your most recent tax forms will be requested if accepted into the program.

What is your family income range? *

How many people are in your household? *

If you did not file an income tax return for the most recent year, please indicate your source(s) * *

PARENT/GUARDIAN - I certify that my responses on this form are accurate and complete to the best of *

Signature Type: Simple Start Over

Reset Signature Pad

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Reset

Signature: (Type in your full name)

I agree to the terms included.