Illinois Central College

Upward Bound Application

All fields marked with the * are required.

Student Contact Information

Student Demographics

Student High School Information

Parent/Guardian Information

Additional Parent/Guardian Information

Household Information

If you would like a copy of your application, please make sure you include an email within the student contact information.

Signatures

I certify that the information in this application is complete and accurate to the best of my knowledge. I understand that submission of false or misleading information can result in disqualification from the program.