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NEW STUDENT APPLICATION 
   
Thank you for your interest in ASU TRIO Upward Bound serving Phoenix Union High School District (PXU) and high schools within Maricopa County at ASU Tempe campus.   
 
Please complete this new student application as thoroughly as possible as you cannot save and restart this application. We recommend reviewing the application questions including links and then returning to this application once you have collected the necessary information. If you have any questions, please call our office at (480) 965-6483 or email us at TRIOUB@asu.edu.  
 
Items listed with (*) are required fields. 
                                                         
                                                     
                                                       
                                                    
                                                    
                                                 
                                                                                                
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                                                            Check box to receive text messages at phone number above
                                                            
                                                         
                                                        
                                                                                                                    
                                                            
                                                            
                                                                                                                    
                                                                                                                    
                                                            
                                                            
                                                            
                                                        
                                                         
                                                     
                                                    
                                                       
                                                    
                                                    
                                                 
                                                                                                
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                                                            Check box to receive text messages at phone number above
                                                            
                                                         
                                                        
                                                                                                                    
                                                            
                                                            
                                                                                                                    
                                                                                                                    
                                                            
                                                            
                                                            
                                                        
                                                         
                                                     
                                                    
                                                       
                                                    
                                                    
                                                 
                                                                                                
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                                                            Race/Ethnicity: (please check all that apply)
                                                         
                                                     
                                                       
                                                    
                                                    
                                                 
                                                                                                
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                                                            Black or African American
                                                            
                                                         
                                                        
                                                                                                                    
                                                            
                                                            
                                                                                                                    
                                                                                                                    
                                                            
                                                            
                                                            
                                                        
                                                         
                                                     
                                                    
                                                       
                                                    
                                                    
                                                 
                                                                                                
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                                                            Native Hawaiian or Other Pacific Islander
                                                            
                                                         
                                                        
                                                                                                                    
                                                            
                                                            
                                                                                                                    
                                                                                                                    
                                                            
                                                            
                                                            
                                                        
                                                         
                                                     
                                                    
                                                       
                                                    
                                                    
                                                 
                                                                                                
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                                                            Please enter 0.001 if you do not have a high school grade point average (GPA).
                                                         
                                                     
                                                       
                                                    
                                                    
                                                 
                                                                                                
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		| 
                                                 
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                 
                                                
                                                    
                                                        
                                                            What will a college education mean to you?
                                                            *
                                                         
                                                        
                                                                                                                    
                                                            
                                                            
                                                                                                                    
                                                                                                                    
                                                            
                                                            
                                                            
                                                        
                                                         
                                                     
                                                    
                                                       
                                                    
                                                    
                                                 
                                                                                                
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		| 
                                                 
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                 
                                                
                                                    
                                                        
                                                            What makes you unique among your peers?
                                                            *
                                                         
                                                        
                                                                                                                    
                                                            
                                                            
                                                                                                                    
                                                                                                                    
                                                            
                                                            
                                                            
                                                        
                                                         
                                                     
                                                    
                                                       
                                                    
                                                    
                                                 
                                                                                                
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		| 
                                                 
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                 
                                                
                                                    
                                                    
                                                        
                                                            Please check your reason(s) for applying:
                                                         
                                                     
                                                       
                                                    
                                                    
                                                 
                                                                                                
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                                                            Academic Advising & Tutoring
                                                            
                                                         
                                                        
                                                                                                                    
                                                            
                                                            
                                                                                                                    
                                                                                                                    
                                                            
                                                            
                                                            
                                                        
                                                         
                                                     
                                                    
                                                       
                                                    
                                                    
                                                 
                                                                                                
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		| 
                                                 
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                 
                                                
                                                    
                                                        
                                                            College Planning & Exploration
                                                            
                                                         
                                                        
                                                                                                                    
                                                            
                                                            
                                                                                                                    
                                                                                                                    
                                                            
                                                            
                                                            
                                                        
                                                         
                                                     
                                                    
                                                       
                                                    
                                                    
                                                 
                                                                                                
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                                                            Career Planning & Exploration
                                                            
                                                         
                                                        
                                                                                                                    
                                                            
                                                            
                                                                                                                    
                                                                                                                    
                                                            
                                                            
                                                            
                                                        
                                                         
                                                     
                                                    
                                                       
                                                    
                                                    
                                                 
                                                                                                
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                                                            Financial Aid & Scholarship Information
                                                            
                                                         
                                                        
                                                                                                                    
                                                            
                                                            
                                                                                                                    
                                                                                                                    
                                                            
                                                            
                                                            
                                                        
                                                         
                                                     
                                                    
                                                       
                                                    
                                                    
                                                 
                                                                                                
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                                                            Computer & Other Technology Access
                                                            
                                                         
                                                        
                                                                                                                    
                                                            
                                                            
                                                                                                                    
                                                                                                                    
                                                            
                                                            
                                                            
                                                        
                                                         
                                                     
                                                    
                                                       
                                                    
                                                    
                                                 
                                                                                                
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		| 
                                                 
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                 
                                                
                                                    
                                                        
                                                            College Visits & Cultural Field Trips
                                                            
                                                         
                                                        
                                                                                                                    
                                                            
                                                            
                                                                                                                    
                                                                                                                    
                                                            
                                                            
                                                            
                                                        
                                                         
                                                     
                                                    
                                                       
                                                    
                                                    
                                                 
                                                                                                
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                                                            Please check your education plan(s) after high school:
                                                         
                                                     
                                                       
                                                    
                                                    
                                                 
                                                                                                
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                                                            Attend a community college
                                                            
                                                         
                                                        
                                                                                                                    
                                                            
                                                            
                                                                                                                    
                                                                                                                    
                                                            
                                                            
                                                            
                                                        
                                                         
                                                     
                                                    
                                                       
                                                    
                                                    
                                                 
                                                                                                
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                                                            Attend a technical/vocational school
                                                            
                                                         
                                                        
                                                                                                                    
                                                            
                                                            
                                                                                                                    
                                                                                                                    
                                                            
                                                            
                                                            
                                                        
                                                         
                                                     
                                                    
                                                       
                                                    
                                                    
                                                 
                                                                                                
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                                                            Join the Armed Forces (Army, Marine Corps, Navy, Air Force, Coast Guard)
                                                            
                                                         
                                                        
                                                                                                                    
                                                            
                                                            
                                                                                                                    
                                                                                                                    
                                                            
                                                            
                                                            
                                                        
                                                         
                                                     
                                                    
                                                       
                                                    
                                                    
                                                 
                                                                                                
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                                                            I am undecided about my education plan
                                                            
                                                         
                                                        
                                                                                                                    
                                                            
                                                            
                                                                                                                    
                                                                                                                    
                                                            
                                                            
                                                            
                                                        
                                                         
                                                     
                                                    
                                                       
                                                    
                                                    
                                                 
                                                                                                
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		| 
                                                 
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                    
                                                 
                                                
                                                    
                                                        
                                                            I do not plan to continue my education
                                                            
                                                         
                                                        
                                                                                                                    
                                                            
                                                            
                                                                                                                    
                                                                                                                    
                                                            
                                                            
                                                            
                                                        
                                                         
                                                     
                                                    
                                                       
                                                    
                                                    
                                                 
                                                                                                
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                                                            Other (see my education plan below)
                                                            
                                                         
                                                        
                                                                                                                    
                                                            
                                                            
                                                                                                                    
                                                                                                                    
                                                            
                                                            
                                                            
                                                        
                                                         
                                                     
                                                    
                                                       
                                                    
                                                    
                                                 
                                                                                                
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                                                            How many people are in your family including yourself?
                                                            *
                                                         
                                                        
                                                     
                                                    
                                                       
                                                    
                                                    
                                                 
                                                                                                
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                                                            If available, please enter the dollar amount on Line 15 of your family's most recent 1040 federal tax form. 
If applicable, please enter N/A if you are an orphan or ward of the court. 
Click Here to view Federal TRIO Programs Current-Year Low-Income Levels. 
                                                         
                                                     
                                                       
                                                    
                                                    
                                                 
                                                                                                
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                                                            Is this your natural or adoptive parent?
                                                            *
                                                         
                                                        
                                                     
                                                    
                                                       
                                                    
                                                    
                                                 
                                                                                                
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                                                            Check box to receive text messages at phone number above
                                                            
                                                         
                                                        
                                                                                                                    
                                                            
                                                            
                                                                                                                    
                                                                                                                    
                                                            
                                                            
                                                            
                                                        
                                                         
                                                     
                                                    
                                                       
                                                    
                                                    
                                                 
                                                                                                
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                                                            Highest Level of Education Completed
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                                                            Is this your natural or adoptive parent?
                                                            
                                                         
                                                        
                                                     
                                                    
                                                       
                                                    
                                                    
                                                 
                                                                                                
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                                                            Check box if contact information is the same as Parent 1
                                                            
                                                         
                                                        
                                                                                                                    
                                                            
                                                            
                                                                                                                    
                                                                                                                    
                                                            
                                                            
                                                            
                                                        
                                                         
                                                     
                                                    
                                                       
                                                    
                                                    
                                                 
                                                                                                
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                                                            Check box to receive text messages at phone number above
                                                            
                                                         
                                                        
                                                                                                                    
                                                            
                                                            
                                                                                                                    
                                                                                                                    
                                                            
                                                            
                                                            
                                                        
                                                         
                                                     
                                                    
                                                       
                                                    
                                                    
                                                 
                                                                                                
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                                                            Highest Level of Education Completed
                                                            
                                                         
                                                        
                                                     
                                                    
                                                       
                                                    
                                                    
                                                 
                                                                                                
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                                                            The information provided on this application will be used to communicate with students and families about Arizona State University events and enrollment.
                                                         
                                                     
                                                       
                                                    
                                                    
                                                 
                                                                                                
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                                                            I understand and accept the conditions listed above: 
                                                            *
                                                         
                                                        
                                                     
                                                    
                                                       
                                                    
                                                    
                                                 
                                                                                                
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                                                            I am interested in receiving information about ASU Family Hub: 
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                                                            Student Agreement 
I agree that if I am accepted into ASU TRIO Upward Bound, I pledge to: 
    - Attend all meetings, advising sessions, tutoring sessions, activities and/or field trips, both in-person and virtual.
 
    - Be an active participant in ASU TRIO Upward Bound through the end of the summer after my high school graduation.
 
    - Attend classes regularly and work to maintain a 2.5 or higher GPA each semester; I understand that I will be on academic probation if my GPA drops below a 2.5.
 
    - Attend tutoring if I receive a grade C or lower in any of my academic classes.
 
    - Graduate from high school.
 
    - Cooperate and behave in a mature, responsible way with ASU TRIO Upward Bound staff and students as well as follow the ABOR Student Code of Conduct.
 
    - Enter a postsecondary educational program upon completion of ASU TRIO Upward Bound.
 
    - Provide follow-up information to ASU TRIO Upward Bound concerning my success in obtaining a postsecondary degree.
 
 
By signing my name, I acknowledge that participation in all ASU TRIO Upward Bound activities is vital to my success.  I agree to follow the above rules and understand that violation of these rules may result in dismissal from the program. 
                                                         
                                                     
                                                       
                                                    
                                                    
                                                 
                                                                                                
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                                                                        Please select a signature verification type. 
                                                                     
                                                            
                                                                    
                                        
                                                                        
                                                                        
                                                                        
                                                                        
                                                                        
                                                                        
                                                                        
                                                                     
                                                                 
                                                             
                                                         
                                                    
			 
		 
                                                    
                                                 
                                                                                                
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                                                            Parent Agreement 
    - I grant permission for my child to participate in Arizona State University (ASU) TRIO Upward Bound and receive the services provided in person or virtually. (Examples: myASU, Canvas, Zoom, Remind, PhotoStudy by Got It, Google Suite, MS Suite)
 
    - I grant permission for my child to participant in group activities, field trips, and one-to-one sessions with staff.
 
    - I agree to encourage my child to do well in high school and pursue postsecondary education.
 
    - I give ASU TRIO Upward Bound staff permission to access grades, progress report, school transcripts, assessment test scores, attendance records, and updated contact information from school personnel and/or school database systems. (Examples: StudentVue, ParentVue, Synergy)
 
    - I authorize ASU TRIO Upward Bound to obtain information related to my child's application for college admission and acceptance status, financial aid applications (FAFSA and scholarships), and award letter to any and all colleges and universities.
 
    - I give consent for my child's information, including name, picture, graduate status, college, major or any awards or scholarships that I receive to be used by ASU TRIO Upward Bound in publications or ASU display cases to promote the success of TRIO students.
 
    - I agree to attend ASU TRIO Upward Bound sessions involving parents provided in-person or virtually.
 
 
By signing my name, I certify that each response within this application is true and complete to the best of my knowledge.  I acknowledge and give consent to the requests of ASU TRIO Upward Bound. 
                                                         
                                                     
                                                       
                                                    
                                                    
                                                 
                                                                                                
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                                                                        Please select a signature verification type. 
                                                                     
                                                            
                                                                    
                                        
                                                                        
                                                                        
                                                                        
                                                                        
                                                                        
                                                                        
                                                                        
                                                                     
                                                                 
                                                             
                                                         
                                                    
			 
		 
                                                    
                                                 
                                                                                                
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                                                            ASU TRIO Upward Bound is a federally funded college access and success program sponsored by the U.S. Department of Education preparing first-generation college bound high school students to enter and succeed in higher education. Click here to learn more.
                                                         
                                                     
                                                       
                                                    
                                                    
                                                 
                                                                                                
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                                                            Privacy Act:  In accordance with the Privacy Act of 1974 (Public Law 93-579, 5 U.S.C. 552a), you are hereby notified that the U.S. Department of Education is authorized to collect information to implement the Upward Bound program under Title IV of the Higher Education Act of 1965, as amended (Public Law 102-325, Sec. 402c).  In accordance with this authority, the Department receives and maintains personal information on participants in the Upward Bound program.  The principle purpose for collecting this information is to administer the program, including tracking and evaluating participants’ academic progress.  The information that is collected on this application will be retained in the program files and may be released to other Department officials in the performance of official duties. 
                                                         
                                                     
                                                       
                                                    
                                                    
                                                 
                                                                                                
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