Thank you for your interest in Upward Bound at Mineral Area College. You cannot save and restart this application so be sure to have your 2022 taxable income from LINE 15 of your 2022 tax form available before you start. A parent signature is also required. For questions or assistance call (573) 518-2156.

Upward Bound Application

First Name *

Middle Name *

Last Name *

LEGAL Gender *

Date of Birth (MM/DD/YYYY) *

School District *

Grade *

Address *

Local City *

State *

Zip Code *

Cell Phone Number

Who do you live with?

Contact 1 Name *

Relationship to student *

Cell Phone Number

Home Phone Number

Work Phone Number

Name (Adult 2)

Relationship to student

Cell Phone Number

List someone outside of your house hold we could contact in case of an emergency.

Name

Relationship to student

Cell Phone Number

Eligibility

Are you a United States citizen? *

If you are not a citizen, list status

Does the student's natural or adoptive parent have a bachelors (4 year college) degree? *

If yes, list the person with degree, type of degree, and name of college that issued the degree.

Did you file your 2022 federal tax return? *

What is the amount listed on LINE 15 of your 2022 federal tax form? This is your taxable income. *

How many people are living in your home ? The student should be included. *

List everyone who lives in your home and their relationship to the student (example: John Smith - father, Jane Smith - mother).

Are you an orphan?

Are you a ward of the court?

If yes, what circuit or county?