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The following is the student section of the Ohio State ATI Upward Bound, Wooster, OH program application. The parent section of the application will be mailed upon receipt and review of the student section of the application. You may call the Upward Bound office at 330-287-1285 if you would like to follow-up on your application. Note* You must be enrolled or planning to enroll in Wooster High School, Orrville High School, McKinley High School, or Timken Early College High School to be considered for application acceptance.

Last Name *

First Name *

Middle Initial *

Students Email

Parent(s)/Guardian(s) Name *

Parent(s)/Guardian(s) Phone

Student's Home Phone *

Students Mobile Phone

Address *

Address Line 2

City *

State * ALAKARAZCACOCTDEDCFLGAHIIDILINIAKSKYLAMEMHMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY

Postal Code *

Students Gender *

Male

Female

Students T-shirt Size *

Are you Hispanic? *

Yes

No

Race - Check all that apply *

Black or African American

White

American Indian/Alaskan Native

Native Hawaiian or Pacific Islander

Asian

Students Date of Birth *

Is the student a U.S. Citizen? *

Yes

No

Students Current Grade Level *

8th

9th

10th

11th

12th

Students Current GPA *

Name of School Currently Attending *

Note*You must be enrolled or planning to enroll in Wooster High School, Orrville High School, McKinley High School, Timken High School, or Timken Early College High School to be considered for application acceptance.

Name of School Attending next year *

Family Income Level *

$0-$10,000

$10,001-$20,000

$20,001-$30,000

$30,001-$40,000

$40,001-$50,000

$50,001-$60,000

Greater than $60,000

Number of members in family *

Have you applied to another Upward Bound program? *

Yes

No

Does the students mother or father have a 4-year college degree? *

Yes

No

What are your educational goals? *

Why do you want to go to college? *

Do you have any questions or comments?

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