Upward Bound

Interest Form


Centralia College Upward Bound is a supportive community that prepares high school students who have limited access to higher education opportunities by assisting students in gaining the knowledge, skills, and resolve required to graduate from high school, and enroll in and graduate from college.


Welcome/instructions:

If you are interested in joining the Centralia College Upward Bound program, complete this short interest form.

Make sure to include at least one type of parent/guardian contact information (phone number or email).

Upward Bound staff will contact you within one week of receiving this form.


Statement of confidentiality/funding:

The information you provide in this application is confidential according to the Family Education Rights and Privacy Act. The U.S. Department of Education has the authority to gather the information requested in this application (20 USC 1231a). The only persons authorized to examine the contents of this application are the student, their parents, employees at the school attended, and authorized Upward Bound staff. 

The Centralia College Upward Bound TRIO project is 100% federally funded at $297,601 annually.


Contact Information:

First Name *
Last Name *
Current High School *
Current Grade Level *
Student Email Address *
Student Phone Number
Parent/Guardian First Name *
Parent/Guardian Last Name *
Parent/Guardian Relationship
Parent/Guardian Email Address
Parent/Guardian Phone Number
Preferred Language for Application *