University of New Meixco Valencia Campus

Upward Bound Program
Pre-Application

1. Name: Last, First, MI
 
2. Mailing Address: Street City State Zip
 
3. Parent Phone Number:
4. Student Phone Number:
5. E-mail address
 
6. Date of Birth: (MMDDYYYY)
7. Gender
8. Social Security Number:
9. High School and Current Grade
Belen High School  
Los Lunas High School  
Valencia High School  
Current Grade   
10. Are you a U.S. Citizen or Permanent Resident?
11. Primary Language:
English  
Spanish  
Other   
12. The University of New Mexico is required by Federal law to request this information for statistical reporting purposes. Your response is voluntary.
13. Do you consider yourself to be Hispanic/Latino?
Yes  
No  
14. In addition, select one or more of the following ethnic categories to describe yourself. 
Asian  
Black or African America  
Hispanic or Latino  
Native Hawaiian or Other Pacific Islander  
White  
American Indian/Alaskan Native (Your principal tribe)   
15. Are you are a first generation student( neither parent or legal guardian has completed a bachelor's degree from an accredited college)?
Yes  
No  
16. 

Select one of the statements below regarding income that applies to you:

Note: For families with more than 8 persons, add $6,270 for each additional family members

 Total number of people in householdFamily Taxable IncomeExact Income
One person- yourself included$18,090 or below
Two persons- yourself included$24,360 or below
Three persons-yourself included$30,630 or below
Four persons-yourself included$36,900 or below
Five persons-yourself included$43,170 or below
Six persons-yourself included$49,440 or below
Seven persons-yourself included$55,710 or below
Eight persons-yourself included$61,980 or below