2023-2024 Upward Bound Interest Form
Thank you for your interest in EMU Upward Bound. Please complete the following information to the best of your ability. Please be aware that there are elements of this application that you may have to sign and/or physically turn in when conditions allow.

Note: The information that is requested on this application is necessary to insure that the applicant meets the eligibility criteria for admission as established by the U.S. Department of Education. All information on this application is for use solely by the Upward Bound program and will be held in strict confidence. The Upward Bound program is sponsored by Eastern Michigan University through a grant funded by the U.S. Department of Education Office of TRIO Programs. Extremely sensitive information, such as tax and account information will not be collected on this form. All of the information we collect is governed by strict standards of privacy. If there are questions regarding EMU Upward Bound, its privacy practices, or its data storage measures, please contact the UB office at (734)487-0488 or email us at upwardbound@emich.edu.
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Student Last Name *
Student First Name *
Today's Date *
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Were you referred to the program by another student? If so, please enter their name here:
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