2023-2024 VUB Program Application with W9 and DD214

All personal information provided is for documentation of eligibility only.  All responses are confidential and protected by the Family Educational Rights and Privacy Act (FERPA).  We will contact you soon about next steps. Thank you.

* denotes a required field

Part I: Personal Information

Part II: Contact Information

From time to time, Grand Valley State University Veterans Upward Bound would like to send text messages, such as program updates and event invitations, to your phone. Carrier rates may apply.

Part III: Eligibility Information

Thank you for your interest. Only those meeting the eligibility requirements of military service for the program are eligible.

Thank you for your interest. Only veterans with a discharge other than dishonorable are eligible for this program.

Eligibility Requirements (Check All That Apply) *

Thank you for disclosing. Answering YES does not necessarily disqualify you from participation in the program.

Part IV: Academic Need

Thank you for your interest. Only those without a four-year degree are eligible for the program.

Part V: Taxable Household Income Last Year (Required by the US Department of Education)

*Taxable Income: This information is located on tax forms (1040-line 43, 1040A-line 27, 1040EZ-line 6).

Part VI: Services

What type of service(s) can Veterans Upward Bound provide for you? (Check all that apply.) *

Part VII: Demographic Information

The following information is required by the federal government for our grant. It will not be used as a basis for selection.

Ethnicity (Check all that apply) *

Referral Information

How did you find out about the VUB program? *

IRS W9 Form

Please complete and upload the FW9 from the IRS Website for stipends.


Check each box to certify the following: *

Applicant Signature *

(Sign Below Using Touchscreen or Mouse)

Human Verification *

Page last modified April 29, 2024