Online Application


PART I: BASIC / PERSONAL INFORMATION



PART II: ELIGIBILITY INFORMATION

 Please complete the chart below on your parents/guardians education:

(Check all that apply) Father / Male Guardian Mother / Female Guardian
Attended Completed Attended Completed
Elementary
High School
2-year College/University
4-year College/University

INCOME VERIFICATION

 An application cannot be considered without verification of income
  • What was your Taxable Income (1040-line 43, 1040A-line 27, 1040EZ-line 6)? $
  • Number of Dependents (exemptions) claimed:
  • I did not file taxes last year

 Employment Status:
 Do you have a documented service related disability? YES  NO


 PART III: EDUCATIONAL INFORMATION

 Did you graduate from high school? YES  NO
   If YES, what year:
   If NO, did you receive a GED certificate? YES  NO
      If you received a GED, what year did you receive it?

 Have you previously attended any post-secondary institution? YES  NO
   If YES, what year:
   If YES, what institution:

 Are you currently attending a post-secondary institution? YES  NO
   If YES, what institution:



How did you hear about this program? (Please check all that apply)

  Transition Assistance Program (TAP)
 Year completed:

  Social Media
 Please specify:

  Personal Referral
 Name of referrer (optional):

  UT Arlington Website

  Other (please specify)

Failure to complete this portion will result in your application review being delayed.

I certify that this application information is complete and correct to the best of my knowledge. If my application is accepted, I agree to abide by the policies, rules, and regulations at the University of Texas at Arlington. Furthermore, I authorize the University of Texas at Arlington TRiO Pre-College Programs to verify the information I have provided. I understand that this information will be relied upon by officials of the University in determining my eligibility for the program and that submission of false information is grounds for denial of my application, withdrawal of an offer of acceptance, cancellation of enrollment, and/or any other appropriate disciplinary action. I also authorize the University of Texas at Arlington TRiO Pre-College Programs to electronically access my records possessed at The University of Texas at Arlington.

    


NOTICE: You may be entitled to know what information The University of Texas at Arlington (UT Arlington) collects concerning you. You may review and have UT Arlington correct this information according to procedures set forth in UTS 139. The law is found in sections 552.021, 552.023 and 559.004 of the Texas Government Code.


UT Arlington Veterans Upward Bound
P.O. Box 19345
Arlington, Texas 76019-0345

Phone: (817) 272-9VUB(882)
Fax: (817) 272-9883

Email: veteransub@uta.edu

University of Texas at Arlington
Location: 406 Summit Ave.,
Arlington, TX See map here