Upward Bound at the University of Wisconsin- La Crosse Instructions for Application

Upward Bound is a federally funded TRIO program that provides academic support to low income students and/or first-generation college bound students. To qualify, students need to either meet TRIO low income guidelines or be a firs tgeneration college, meaning neither parent has obtained a bachelor's degree. To qualify, students must have at least started the Ninth Grade and either attend one of our program's target high schools that includeLogan, Central, Onalaska, Brookewood, Holmen, or Spartaor any of the high schools in Monroe or La Crosse County. Student's attending the target high schools are given priory in the admissions

Dear student, I am pleased that you are interested in Upward Bound.

In this application, students will need to: 

o    Complete the 2020-2021 student application

o    Complete the letter of recommendation form (ask a teacher or school counselor)  

o    Request high school transcript and most recent test scores

o    You and your parents or legal guardian should complete the data sheet. You will need to submit one of the following: A copy of your United States birth Certificate or permanent resident card

Parent’s will need to:

o    Complete the Statement of Family Income Form

o    Submit a copy of Income Verification (tax forms) 

o    Complete the Parental Consent, Waiver and Release Form 

Both Student and Parent/Guardian will need to:

o    Read and Sign the Required Expectations for Student Participation 

o    Complete the Release of Student information

o    Complete the Media Release Form (Optional) 

o    Printed Applications can be submitted to your school’s counselor or mail to the Upward Bound office at the following address:  

Upward Bound at UWL

1725 State Street-176 Murphy Library

La Crosse, WI 54601

Please feel free to contact me via email sspivey@uwlax.edu  with any questions and I look forward to receiving your application.

 

Sincerely, 

Shaundel Spivey

Director of Upward Bound 

Upward Bound at the University of WisconsinLa Crosse Parental Consent, Waiver and Release

I, the parent/legal guardian of the student, give my consent of their participation in the Upward Bound Program being sponsored by the University of WisconsinLa Crosse and the Monroe and La Crosse Counties. I understand my child will be attending after school classes and tutoring sessions at the university during the school year and be attending a sixweek summer residential program at the University of Wisconsin La Crosse during the summer. I understand that the university has made no representation concerning the safety of the methods of travel to and from our travel sites visited.

I hereby agree, on behalf of myself and my child, to assume all of the risks in connection with my child’s attendance at and participation in the Upward Bound Program, including travel, and I agree to release the University of Wisconsin la Crosse from any and allliabilities and claims whatsoever arising in connection with my child’s attendance and participation, including travel, except insofar as such liabilities and claims arise out of University of WisconsinLa Crosse’s negligence or willful misconduct.

I consent to and authorize emergency and nonemergency medical care to be provided to my child in the event of a health problem, emergency or injury occurring during my child’s attendance at or in the event of a health problem, emergency or injuryoccurring during my child attendance at or participationin the University of WisconsinLa Crosse Upward Bound Program. I give my consent and authorizationto the Upward Bound Directoror their designee to use their judgment in seeking medical care for my child. I understand that an attempt will be made to contact me ifemergency medicalcare is needed.

I agree that the laws of theState of Wisconsin shall govern this Waiver & Release. I afform that I have read and understood this document.

 

Certification: All of the information on this application is true and correct to the best of my knowledge. If asked by an authorized official, I agree to give proof of the information that we have given on this application. I also realize that purposely giving false of misleading information on this application may result in a fine, a prison sentence, or both. I also realize that if I do not give proof when asked, that my child will be denied admittance to Upward bound at the University of Wisconsin La Crosse.

 

The student’s parents or legal guardian must complete this statement. Please answer the questions below and sign the certification that follows. To be income eligible for Upward Bound, a students Family taxable income for the year proper cannot exceed 150 percent of the poverty level. For specifics and the taxable income levels, please visit

Certification:All of the information on this application is true and correct to the best of my knowledge. If asked by an authorized official, I agree to give proof of the information that we have given on this application. I also realize that purposely giving false of misleading information on this application may result in a fine, a prison sentence, or both. I also realize that if I do not give proof when asked, that my child will be denied admittance to Upward bound at the University of Wisconsin La Crosse.

 

To the high school teacher or school counselor:

Upward Bound is a higher education opportunity program offered by the University of Wisconsin – La Crosse. During the academic year, the students come to the University of Wisconsin- La Crosse, or we come to the High School, for tutoring and programming. During the summer, the students live on the University of Wisconsin La Crosse’s campus and have a full-time schedule of rigorous academic activities for six weeks.

Please assess the above student potential to be successful participant in the program. We would appreciate your comments on the student ability in any of the following areas: initiative sense of responsibility, intellectual curiosity and imagination, desire to go to college, writing and oral expression, working with and relating to others, common sense and good judgment, and persistence to carry through on tasks. Please indicate how long you have known the student and the course in which you have had the student.

You may return this recommendation to the student, or mail it or hand deliver it to

University of Wisconsin La Crosse Upward Bound 1631 Pine Street; Murphy Library RM 176 La Crosse, WI 54601

Or you may use this link here to fill out the information: Teacher Recommendation Form https://form.jotform.com/ccolonriverauwl/school-recommendation-form)

Upward Bound at the University of Wisconsin La Crosse Required expectation for student participation

I understand that Upward Bound requires students to do the following:

1. Students are expected to remain in Upward Bound through high school graduation.
2. Students are required to participate in both the six-week summer program and the after-school program.

• During the summer program students live in a residence hall on the University of Wisconsin La Crosse campus from Sunday night through Friday afternoon.
• During the school year, students will either commute to the University of Wisconsin La Crosse campus after school or stay after school at their respective high school that hosts UB staff for weekly tutoring, enrichment classes, and workshops to assist with college and financial aid application process.

3. Students are expected to follow the rules and regulations of Upward bound and UW- La Crosse. Full copies of the Upward Bound rules and regulations are distributed at the start of the fall semester, spring semester and summer program, and are also available upon request. Students and parents are expected to read the full version of the program’s rules and regulations. The program rules can be summarized as follows.

• Students are expected to earn at least the grade of a C in all their high school classes each marking term. If a student earns a grade below a C, Upward Bound will place them on academic probation. Any student on academic probation for three consecutive marking terms could be dismissed from the program.
• Students are expected to be on time and prepared for all program classes and activities. Students are always expected to show respect for themselves and to others.
• Students are expected to follow reasonable staff directives. Students are not allowed to have non program friends as visitor on the UW-La Crosse campus while participating in upward Bound.
• Students are expected to inform Upward Bound Staff of their whereabouts and during the summer program students are required to sign in and out of the resident hall after 7 PM.
• Students are expected to observe the programs curfew and lights out policy during the summer program.
• Students may not use cell phones or other mobile communication devices during class or other program activities.
• Students are not allowed to leave the UW- La Crosse campus during the summer program.
• Students will be dismissed for any of the following infractions: possession or use of illegal drugs, alcohol, weapons or fireworks; physical violence or the threat of physical violence; intentional destruction of property (including graffiti); taking of someone else’s property without their permission; and during the summer student are not allowed in the dormitory area restricted for the opposite sex nor are they allowed to use the dormitory or dining hall outside of approved times.

Permission to Release Student information to Upward Bound

I, the parent/legal guardian of release of my son/daughter’s academic records including but not limited to courses, grades, individual education plans, standardized test scores, and proof of graduation to upward Bound at the University of Wisconsin La Crosse for the purposes of tracking student progress, and compiling and reporting data to the United States Department of Education, Office of Post-Secondary Education. I understand that the United states Department of Education requires Upward Bound at the University of Wisconsin La Crosse to report on my child’s academic progress through either his or her graduation from college or at least four years after my child’s high school graduation.

 

I, the student, do hereby permit the release of my academic records including but not limited to courses, grades, individual education plans, standardized test scores, and proof of graduation to Upward Bound at the University of Wisconsin La Crosse for the purposes of tracking student progress, and compiling and reporting data to the United States Department of Education, Office of Post-Secondary Education. I understand that the United states Department of Education requires Upward Bound at the University of Wisconsin La Crosse to report on my academic progress through either my graduation from college or at least four years after my high school graduation.

 

I, the parent/legal guardian of Upward Bound at the University of Wisconsin La Crosse to release the academic records about my son/daughter and his/her participation in Upward Bound to the La Crosse or Monroe County Public Schools, and the Wisconsin Office of Education, and to the US department of Education for legitimate educational interests.

Signature of Parent or legal Guardian Date

I, do hereby permit the Upward Bound at the University of Wisconsin La Crosse to release the academic records about me and my participation in Upward Bound to the La Crosse or Monroe County Public Schools, and the Wisconsin Office of Education, and to the US department of Education for legitimate educational interests.

Student’s Signature Date

I hereby give my permission to University of Wisconsin La Crosse to photograph, film, videotape and/or make sound recording of my child, to quote or publish statements of my child and to use such photographs, films, and videotapes, sound recordings and/or other statements in the University of Wisconsin La Crosse educational and promotional/advertising materials and for other purposes specified below. I understand that my child may be identified in any photographs news stories, or publications that the University of Wisconsin La Crosse considers appropriate for release to magazines, newspapers University of Wisconsin La Crosse’s World Wide Web site, and/or other publication. I further understand that nay such photographs, films, videotapes, sound records and/or written works are the property of University of Wisconsin La Crosse and that neither my child nor I am entitled to any compensation for or rights to these materials.

I release University of Wisconsin La Crosse from all liability with respect to the matters covered by this release.