Upward Bound (UB) Interest Form - Chesapeake College
Thank you for your interest in our Upward Bound program at Chesapeake College! We are excited to see your commitment to continue your education after high school. Due to the high number of applications we receive every year, we would like to learn a bit more about you before we begin the application process.

Please complete this form below and a member of our UB Staff will contact you. If you have any questions while completing this form, please reach out to the Academic Coordinator assigned to your school. 
Email *
Student ID Number
Student First Name *
Student Last Name *
Student Phone Number *
Address (include city, state, and zip code) *
If necessary, can you (the student) be contacted via text message by the Chesapeake College's TRIO Upward Bound Office about this interest form? *
Parent/Guardian First Name *
Parent/Guardian Last Name *
Parent/Guardian Phone Number *
Parent/Guardian Email Address
Which grade are you currently in? *
Required
Which school do you currently attend? *
Required
Do either of your parents have a Bachelor's Degree from the U.S? *
Required
Do you qualify for or receive free or reduced lunch? *
Required
What is your current GPA? *
Rate your understanding of what it takes to get into college.
 *
I know nothing.
I am an expert.
What is your residential status? *
Required
How did you hear about Upward Bound? *
A copy of your responses will be emailed to the address you provided.
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