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  • Upward Bound Math Science

    Frostburg State University

  • 2026-2027 STUDENT APPLICATION

  • STUDENT INFORMATION

  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Birthdate:*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Sex on Birth Certificate:*
  • Race/Ethnic Identification (check all that apply):*
  • Citizenship Status:*
  • Student resides primarily with:*
  • Orphan or ward of the state?*
  • Current Grade:*
  • How can UBMS help you? Check all that apply.*
  • T-shirt size for program-issued shirt (unisex adult sizes):*

  • APPLICANT ESSAY

  • PARENT/GUARDIAN INFORMATION

  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Do you have a 4-year college degree? (Parent 1)*
  • Marital Status (Parent 1):*
  • Relationship to student (Parent 1):*
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Do you have a 4-year college degree? (Parent 2)
  • Marital Status (Parent 2):
  • Relationship to student (Parent 2):

  • CONFIDENTIAL INCOME CERTIFICATION

    (To be filled out by parent or guardian)

  • *If parents are married and filing separately, both parents' tax information should be added, and the combined taxable income and household members should be reported.

  • 1) If you filed a federal tax return last year, answer the following with information from your most recent tax return. All 8th-grade applicants must use the 2026 tax return from the year they will complete 8th grade.

    You may submit a signed copy of your federal tax return in lieu of completing this section of the application. Copies of tax returns may be requested to verify application materials.

  • Filing Status:
  • 2) If you did not file a federal tax return last year, answer the following:
    Rows
  • Is the student eligible for Free or Reduced Meals at school?*
  • I certify that the income information given above is correct to the best of my knowledge.
  • Date:
     - -
    2 digit month, 2 digit day, 4 digit year

  • Household

    Please list names and ages of family members living in the home.
  • List all adults and children*
    Rows

  • EMERGENCY CONTACTS In case of an emergency, in addition to the parents listed above, whom may we contact?

  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.

  • INSURANCE INFORMATION

  • Does the applicant have health insurance?*
  • Format: (000) 000-0000.
  • Image field 99
  • Upward Bound Math Science
    Frostburg State University
    101 Braddock Road
    Frostburg, MD 21532-1099
    1-800-646-6000

  • CONSENT FORM

  • Consent valid 10/01/2026-09/30/2036

  • PARENTS AND STUDENT MUST READ AND SIGN:

    • Upon request, Upward Bound Math/Science may secure copies of any and all subsequent information and materials relative to the applicant's academic performance, including both high school and college/university transcripts and financial aid information. I (we) realize that the US Department of Education requires the requested data of all current and former participants.
    • I (we) understand that a student participating in Upward Bound Math/Science will be engaged in certain educational and recreational activities, including but not limited to camping, hiking, canoeing, and initiative activities that come with the risk of physical injury. I (we) understand also that various field trips to off-campus locations may be taken under the supervision of Upward Bound Math/Science.

    In consideration of participating in Upward Bound Math/Science, I (we) understand that Frostburg State University (the "University") shall, in no way, be deemed responsible for the operation, safety, and management of any means of transportation, public or private, or off-campus facilities used while participating in Upward Bound Math/Science. I (we) do myself, my heirs, and personal representatives, hereby defend, hold harmless, indemnify, and release the State of Maryland, the University, Upward Bound Math/Science, and all its officers, agents, and employees from and against all claims, demands, and actions, or causes of action, on account of damage to personal property, personal injury, or death which may result from my (our) participation in Upward Bound Math/Science.

    • I (we) understand that all participants must have a physical examination before participating in Upward Bound Math/Science. I (we) understand that I (we) am solely responsible for determining whether the participant has any physical or mental limitations preventing him or her from participating in Upward Bound Math/Science. I (we) further understand that the University has no actual or constructive notice of any such limitation, and hereby release the State of Maryland, the University, and its officers, agents, and employees, from any liability arising from any injuries from such limitation.
    • I (we) give consent for the participant to receive routine and/or emergency medical services (if needed) for the participant's entire enrollment period in Upward Bound Math/Science.

    In signing this application, I (we) understand that my (our) son/daughter is applying for Upward Bound Bound Math/Science. This year-round academic program includes a multi-week summer residential program at Frostburg State University AND an academic year component which primarily meets at target high schools, libraries in Frederick County, and virtually. I understand my (our) child is expected to meet the Academic Expectations of FSU UBMS students.

    • I (we) will supply income verification information upon request.
    • I (we) will supply student citizenship or permanent residency verification upon request.
    • I (we) verify that I (we) have reviewed this application and the information given is correct to the best of my (our) knowledge.

  • Parent(s)/Guardian(s), please sign below:

  • Date:
     - -
    2 digit month, 2 digit day, 4 digit year
  • Date:
     - -
    2 digit month, 2 digit day, 4 digit year

  • Student, please sign:

  • Date:
     - -
    2 digit month, 2 digit day, 4 digit year
  •  
  • Should be Empty: