| Your Info |
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First Name:
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Middle Name:
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Last Name:
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Maiden Name:
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High School Graduation Year:
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High School Name:
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| Current Contact Info |
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Current Address:
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Current City:
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Current Zip: |
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Current Phone:
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Current Cell Phone:
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Current Email:
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Permanent Contact Info
(someone that will always know where you are - e.g. parents) |
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First Name:
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Last Name:
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Address:
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City:
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Zip: |
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Phone:
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Relationship:
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| Educational Tracking Data |
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Current Educational Status:
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attending college
attending vocational/technical training
not attending college or vocational training
completed college or vocational training |
| Tracking Data - First Entry |
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First Entry into PSI (Post Secondary Institution) – if this is your first enrollment in college, please continue – if you were previously enrolled and we already have your First PSI information please skip to the next section.
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Name of First college or
vocational school attended:
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Start date of First college or
vocational school attended:
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Financial Aid Awarded for First Enrollment in PSI:
(check all that apply)
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1 - Pell grant only
2 - FFEL Loan
3 - Direct Loan
4 - College work study only
5 - Institutional aid only
6 - State grant only
7 - Pell grant and FFEL loan
8 - Pell grant and Direct Loan
9 - Multiple Federal Aid
10 - Multiple Federal and other aid
11 - Non-federal, non-institutional aid
12 - No aid awarded
13 - No aid needed
99 - Not applicable (not enrolled in a program of postsecondary education)
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| Tracking Data - Enrollment Info as of this date |
| If you are continuing your post-secondary education please update us on your current college/vocational status. |
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Name of Current college or vocational school:
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Start date of Current college or vocational school:
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Current enrollment status:
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Full-time
Less than full-time
Varied enrollment during current year
Not currently enrolled |
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Current College Grade Level:
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Accepted into PSI but not yet enrolled
First Year, never previously attended
First Year, attended before
2nd year/Sophomore
3rd year/Junior
4th year/Senior
5th year/undergraduate
Completed Associate's Degree; accepted into a 4-year institution
Completed Associate’s Degree; enrolled in a 4-year institution
Enrolled in a graduate degree program
Degree or certificate completed; not currently enrolled in PSI |
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Current Major Field of Study:
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Degree/Certificate Completed:
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Certificate/Diploma for occupational, educational program (less than a two-year program)
Certificate/Diploma for occupational, educational, technical program (at least a two-year program)
Associate Degree (two years)
First Bachelor’s Degree
2nd Bachelor’s Degree
Teaching Credential Program
Graduate or Professional Degree
Enrolled but not yet completed program of postsecondary study
Completed high school; not enrolled in postsecondary education |
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Alumni Directory
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If (in the near future) we create an “alumni” directory to be made available to other Harding University Upward Bound graduates… do you give permission for your current contact information to be included? This directory would be in printed format mailed to graduates that request it. Yes No
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