2021 Upward Bound Summer Program Application

I certify that the above stated information is true and correct to the best of my knowledge and that withholding or falsifying may make me ineligible for admission to the Upward Bound Summer Program.

By submitting this form you release the Family Centered Educational Agency of any liability during the course of the summer program. You also agree that your son or daughter will abide by all the rules and regulations established by the program. Your signature also authorizes us to use any pictures/videos taken in connection with the activities of the virtual FCEA Upward Bound Summer Program to be used in publications (i.e., newsletters, television, website, presentations, magazine articles, etc.)

By entering your name in the box below, you are electronically providing your signature, indicating that all the information on this form is true and accurate, to the best of your knowledge.