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Colorado School of Mines

TRIO Upward Bound Math and Science

Program Application

Thank you so much for your interest in the Colorado School of Mines TRIO Upward Bound Math and Science (UBMS) Program!

UBMS is a FREE federally grant-funded college access program for 9th - 12th grade students at Alameda International Jr/Sr High School interested in pursuing a college degree in math or science. We cater to first-generation, low-income students who are U.S. citizens/residents. UBMS provides tutoring, a 6-week summer program at Colorado School of Mines, success skill workshops, and opportunities to travel nation-wide visiting college campuses. We provide high school students with the tools, resources, and support necessary to graduate high school, enroll in college, as well as explore and pursue careers in math and science fields.

Please note, student and parent/guardian information is required in this application. Unfortunately, there is not a save and return feature. Once we receive your application, we will reach out about next steps. The UBMS admission process requires the following steps:

  • Submit this application
  • Submit writing sample (see writing sample section below for more information)
  • Submit recommendation form
  • Interview with UBMS staff
  • If accepted, submit liability waivers, photo and educational record release forms, and UBMS participant / parent / guardian behavioral expectations contract.

To parent(s) / guardian(s): Personal information given to UBMS is required to determine if your child meets federal eligibility guidelines established by regulation of the U.S. Department of Education. All information is protected under the Family Educational Rights and Privacy Act (FERPA, 20 USC 1231a). Thank you for your interest in the Upward Bound Math and Science Program! Please contact a UBMS staff member if you have any questions or need assistance completing the application.

If you have any questions/concerns, please contact UBMS staff:

Dari Roybal, TRIO UBMS Director - darianaroybal@mines.edu

Stephanie Martinez, TRIO UBMS Coordinator - smartinez3@mines.edu
Applicant General Information:
Legal First Name *
Middle Name
Legal Last Name *
Preferred Name
School ID Number *
Date of Birth *
Assigned Gender at Birth *
Gender Identity *
Preferred Pronouns *
Mailing Address *
Mailing Address 2
City *
State *
Zip *
Applicant Cell Phone Number *
Applicant Email Address *
Is English your first language? *
If no, what is your preferred language
Race *
Ethnicity *
Citizenship Status *
If selected permanent resident, please provide your permanent resident number.
If selected other, please explain.
Dietary Restrictions
T-Shirt Size *
Academic, Career, and Extracurricular Information:
Current Grade Level *
School Counselor Name *
Are you currently a participant of any of the following federally funded programs? *
Please select the option that best describes your current plans for after high school. *
Below, in order of preference, please list two occupations (careers) you would pursue if given the resources and opportunity. Please provide a reason for each of your choices.
Career Interest 1 *
Why? *
Career Interest 2 *
Why? *
Please list any activities, experience, volunteer/community service, clubs, sports, and awards you have earned, experience, or are currently involved in. *

Writing Sample:

Your essay is your opportunity to help us get to know you and your interests! While this is not a research paper, your essay should be written neatly or typed between 250-500 words. Plagiarism will not be accepted. Please use the prompts listed below to help you decide what to include in your writing sample (you do not need to answer all prompts listed).

  • Why do you want to be a part of Upward Bound Math & Science? Specifically, how do you think the program would benefit you?
  • What are your educational/career goals and priorities?
  • What topics in STEM (science, technology, engineering,& mathematics) do you find interesting?
  • What are some of your other interest/priorities in life?
  • What obstacles have you had to overcome to reach this place life? How have you overcome them?
  • Explain what values are most important to you and why.
  • What drives you to make a difference in life?
  • Anything else you may want us to know about you!

SUBMISSION: Please email your essay to smartinez3@mines.edu or hand it in to the TRIO Upward Bound Math & Science office at school.

Please note, your application will not be considered complete until we receive your essay and recommendation.

Parent/Guardian Information:

This section is to be completed by the applicant's parent(s) / legal guardian(s).
Parent/Guardian 1:
Full Name
Relationship to Applicant
Address
City
State
Zip
Phone
Email Address
Has parent/guardian 1 earned a 4-year bachelors degree?
Parent/Guardian 2:
Full Name
Relationship to Applicant
Address
City
State
Zip
Phone
Email Address
Has parent/guardian 2 earned a 4-year bachelors degree?

Income Eligibility Information:

This section is to be completed by the applicant's parent(s) / legal guardian(s).
Does the applicant live in a foster home, or are they a ward of the court (if yes, select N/A on the next question). *
According to the household size and TAXABLE income levels listed below, does your family qualify as low-income? *

**Disconnected youth (i.e., foster care, wards of the court, etc.): No income verification is required. Please provide a signed letter for your foster family / guardian(s) detailing disconnected youth status. Include your caseworker's name and contact information.
By signing below, I (applicant's parent / legal guardian) certify that the income information provided is valid and accurate. 
2023 Income Eligibility Scale
Parent / Legal Guardian Signature *
Signature Type: SMS    Start Over
After validation, the cell phone number will become part of the electronic signature.
Cell Phone Number: