Current Step: Student Information

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Student Information
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Parent/Guardian Information
3
Eligibility Information (To be completed by the Parent/Guardian)
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Parent/Guardian Permission

Application

1 Current
Student Information
2
Parent/Guardian Information
3
Eligibility Information (To be completed by the Parent/Guardian)
4
Parent/Guardian Permission

Application

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The following questions should be completed by the prospective student.

What school does the student attend? Please select one. *

What program is the student applying for? *

TRIO Talent Search is open to 7th-12th Grade at Academy at Shawnee Middle/High, Atherton High, Central High, Fern Creek High, Marion C. Moore Middle/High, Newburg Middle, Southern High, Western Middle.

TRIO Upward Bound is open to 9th-12th Grade at all JCPS High Schools EXCEPT Brown, Grace James, and W.E.B. Dubois

What grade is the student currently in? *

First *

Middle

Last *

Address *

Address 2

City/Town *

ZIP/Postal Code *

STUDENT Telephone Number *

Students Date of Birth *

Students Date of Birth: Year *

Students Date of Birth: Month *

Students Date of Birth: Day *

What is the student's gender? Please select one. *

What is the student's race or ethnic background? *

Is the student a U.S. citizen? *

Students JCPS email *

Students PERSONAL email *

What are the student's career goals? *

Please tell us why (in as much detail as possible) why you want to be a student participant in the TRIO Talent Search or Upward Bound program? *

Student Signature *

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