PARENTAL AGREEMENT
I have read the above requirements and agree to work with my child and
Academic Institute of Central Carolina Upward Bound staff to abide by these requirements. I have read all pages of
this application and fully understand the obligation my child/ward is assuming. I authorize Academic Institute of
Central Carolina’s Upward Bound program to obtain documents relative to my child’s education (report cards,
transcripts, test scores, progress reports, etc). I authorize Academic Institute of Central Carolina’s Upward Bound
program to obtain my child’s college admission, financial aid, and college enrollment information. I will assist my
child/ward in his/her obligation to Academic Institute of Central Carolina’s Upward Bound Program. I give
permission for my and my child’s name, photo, work or statements to be used for promotional, publicity, reporting,
instructional, and verifying purposes. I authorize contact from this agency to communicate with me via cell phone,
cell phone text message, home phone, and email as needed. I certify all information on this application is true and
accurate, including the information about family income to the best of my knowledge.
Parent(s)