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NEW STUDENT APPLICATION

  

Thank you for your interest in ASU TRIO Upward Bound serving Tolleson Union High School District at ASU West.

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 (602)-496-0972 or email us at TRIOTalentSearch@asu.edu. 

Items listed with (*) are required fields.
 Student Information: 
Last Name
First Name
Middle Name
Address 1
Address 2
City
State
Zip
Cell Phone Number
Check box to receive text messages at phone number above
Home Phone Number
Check box to receive text messages at phone number above
Personal Email
High School Email
Citizenship Status
Date of Birth
Gender
Preferred Pronouns
Race/Ethnicity: (please check all that apply)
American Indian / Alaska Native
Asian
Black or African American
White
Native Hawaiian or Other Pacific Islander
Hispanic
 Academic Information: 
Current High School
If you selected "Other" above, please enter the name of your current high school
Current Grade Level
High School ID #
Current Unweighted GPA
Please enter 0.001 if you do not have a high school grade point average (GPA).
High School Counselor's Name
High School Counselor's Email
 Short Answer Questions: 
What will a college education mean to you?
What makes you unique among your peers?
Please check your reason(s) for applying:
Academic Advising & Tutoring
College Planning & Exploration
Career Planning & Exploration
Financial Aid & Scholarship Information
Computer & Other Technology Access
College Visits & Cultural Field Trips
Other (see reason below)
Other reason:
Please check your education plan(s) after high school:
Attend a university
Attend a community college
Attend a technical/vocational school
Join the Armed Forces (Army, Marine Corps, Navy, Air Force, Coast Guard)
I am undecided about my education plan
I do not plan to continue my education
Other (see my education plan below)
Other education plan:
 Family Information: 
How many people are in your family including yourself?
What is your family’s taxable income?

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.
Parent 1
Is this your natural or adoptive parent?
First and Last Name
Address 1
Address 2
City
State
Zip Code
Phone
Check box to receive text messages at phone number above
Email
Preferred Language
Highest Level of Education Completed
Parent 2
Is this your natural or adoptive parent?
First and Last Name
Check box if contact information is the same as Parent 1
Address 1 (if different)
Address 2 (if different)
City (if different)
State (if different)
Zip Code (if different)
Phone (if different)
Check box to receive text messages at phone number above
Email (if different)
Preferred Language
Highest Level of Education Completed
The information provided on this application will be used to communicate with students and families about Arizona State University events and enrollment.  
I understand and accept the conditions listed above:
I am interested in receiving information about ASU Family Hub.
I am interested in receiving information about ASU Family Hub:
 Sign and Submit: 

Student Agreement

I agree that if I am accepted into ASU TRIO Upward Bound, I pledge to:

  1. Attend all meetings, advising sessions, tutoring sessions, activities and/or field trips, both in-person and virtual.
  2. Be an active participant in ASU TRIO Upward Bound through the end of the summer after my high school graduation.
  3. 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.
  4. Attend tutoring if I receive a grade C or lower in any of my academic classes.
  5. Graduate from high school.
  6. 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.
  7. Enter a postsecondary educational program upon completion of ASU TRIO Upward Bound.
  8. 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.
Student Signature
Please select a signature verification type.

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.
Parent Signature
Please select a signature verification type.
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.

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.