VUB Application

Personal Information

First Name *

Middle Name

Last Name *

Date of Birth *

Contact Information

Email *

Phone *

Address Line 1 *

Address Line 2

City *

State/Province *

Zip/Postal Code *

County *

Eligibility

Citizenship Status *

Are you a Veteran? (Have you served in the United States Military to include Active Duty, Reserves, and Guard?) *

Type of Discharge *

Eligibility Requirements (Check All That Apply) *
I have served at least 181 days of Active Duty.
I served on active duty and was discharged or released because of service-connected disability.
I was a member of a reserve component of the Armed Forces, serving on Active Duty for a period of more than thirty (30) days.
I was a member of a reserve component of the Armed Forces who served on Active Duty in support of a contingency operation on or after September 11, 2001.

Have you ever been convicted of a felony or have you been arrested for a crime for which criminal charges are pending? *

Do you have a documented service-related disability? *

Income Verification

The number of individuals living in my household and/or claimed as dependents (including myself) is... *

Please specify your/your family's NET income, after taxes (do NOT include disability benefits, investments, retirement, etc.) *

Academic Need

Did either of your parents (that you live(d) with) receive a 4-year degree from a college/university BEFORE you were 18? *

Did you graduate from high school? *

Have you received a Bachelors degree? *

Have you been out of school for 5 years or more? *

Have you taken the ALEKS assessment or any other placement assessments? *

Services

What type of service(s) can TRIO Veterans Pre-College Services provide for you? *
Financial Aid Application
Scholarships
VA Education Benefits
Workforce Training
Academic Advising
Career Exploration
College Transfer
Financial Literacy
Skilled Trades
Career Credentials or Certifications

If you need support with any services beyond those listed above, please list/describe them here. *

Demographic Information

Gender *

Ethnicity *
American Indian or Alaskan Native
Asian
Black or African American
Hawaiian or Other Pacific Islander
Hispanic or Latino
White
Multi-racial

Have you participated in another TRIO Program during the last 12 months? *

Are you currently employed? *

Acknowledgements

Signature *

I certify that all of the information provided in this application is true and complete to the best of my knowledge.
I understand that the completion of this application does not guarantee acceptance into TRIO Veterans Pre-College Services.
I understand that the completion of this application will be held in confidence by the TRIO Veterans Pre-College Services program.
I understand that membership in Veterans Upward Bound is voluntary and that I may opt-out at any time without further obligation.
I understand that all information, services, and resources received through TRIO Veterans Pre-College Services are free and will not impact my G.I. Bill.
If accepted, as an active participant, I will connect with TRIO Veterans Pre-College Services staff a minimum of two (2) times a month during my membership (acceptable modes of communication/service include face to face, email, phone, workshops, events, text, etc.)
I will notify TRIO Veterans Pre-College Services if my address, phone number, or email address changes.

Supportive Services Pre-Assessment-- for each section, rate how prepared you feel in each area:

I feel prepared to identify my education or training goal *
Not prepared
Somewhat prepared
very prepared

I feel prepared to obtain my high school, college, CCAF or Joint Service Transcripts *
Not prepared
Somewhat prepared
Very prepared

I feel prepared to complete the FAFSA and understand all financial aid options *
Not prepared
Somewhat prepared
Very prepared

I feel prepared to apply for, understand and use VA education and/or Federal Tuition Assistance (TA) benefits *
Not prepared
Somewhat prepared
Very prepared

I feel prepared to apply for and understand the Michigan Reconnect Program *
Not prepared
Somewhat prepared
Very prepared

I feel prepared to read and understand college-level or technical material *
Note prepared
Somewhat prepared
Very prepared

I feel prepared to conduct effective online research *
Not prepared
Somewhat prepared
Very prepared

I feel prepared to navigate an online learning platform *
Not prepared
Somewhat prepared
Very prepared

I feel prepared to write a college-level paper or essay *
Not prepared
Somewhat prepared
Very prepared

I feel prepared to complete the mathematics course appropriate for my chosen academic path *
Not prepared
Somewhat prepared
Very prepared

FERPA Statement

The Family Educational Rights and Privacy Act (FERPA), 20 U.S.C. §1232g, are federal and state laws providing for the review and disclosure of student educational records. Veterans Upward Bound (VUB) TRiO program (TRiO Veterans Pre-College Services) will not permit access to or the release of personally identifiable information contained in student educational records to any party without the written consent of the student, except as authorized by FERPA.

TRiO Veterans Upward Bound (TRIO Veterans Pre-College Services) is funded under a grant from the U.S. Department of Education, Office of Postsecondary Education.

In accordance with the Privacy Act of 1974 (Public Law No. 93-579, 5 U.S.C. 552a), you are hereby notified that the Department of Education is authorized to collect information, including Social Security numbers, to implement the TRIO program under Title IV of the Higher Education Act of 1965, as amended. The principal purpose for gathering this information is to determine an applicant's eligibility for the program and to fulfill federal reporting mandates. The information provided is used to track participant academic progress, measure project performance, and provide aggregate data for Federal evaluation of the TRIO programs. Routine uses of this information include sharing it with institutional administrators and Department of Education personnel for monitoring and evaluating project goals. Under the Privacy Act, your individual information cannot be disclosed outside the Department without your written consent, except as permitted under the system of records notices published in the Federal Register. Providing the requested information, including the Social Security number, is voluntary; failure to disclose will not result in denial of any right, benefit or privilege to which the participant is entitled.

Human Verification *

Page last modified August 26, 2026

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