Upward Bound Eligibility

Name
Grade
School ID #
Social Security #
School
High School Counselor
Permanent Address
Mailing Address
Home Phone #
Message Phone#
Father's Name
Mother's Name
Ethnic Background
Citizen of United States ?	Yes No
If no, describe status
Current GPA	Overall GPA
Are you able to particpate in after school tutorials?	Yes No
What language(s) do you speak most at home?
Are you able to attend monthly College Conferences at CSUF? (Transportation will be provided.)	Yes No
What are your career goals?
Have either of your parents attained a four-year degree?	Yes No
Total number of people living in the household.
Approximate annual total household income
List community activities you are involved in such as, clubs, sports, work, etc.
Please tell us about your determination to complete high school, enter college and graduate from college.
What do you usually do during the summer?