Participant Authorization Form

Participant Date of Birth*

In order to participate in all activities offered through the Front Range Community College TRIO Upward Bound Program during high school and throughout college (up to six years after high school graduation), authorizations  must be obtained by the participant and parent/guardian if participant is under 18 years of age. Please read and sign the following releases.

School Records Release

I do hereby authorize program staff to access both high school and college academic records, including but not limited to, schedules, grades, transcripts, individual education and career plans, standardized test scores, and proof of high school and college graduation of the participant named above. I understand that the information collected is to compile and report data to the US Department of Education on an annual basis regarding participant demographics, academic progress, high school and college completion. I also understand that the TRIO Upward Bound Program Staff will keep this information confidential and stored in a secure location. 

Confirm*

Communication Release

I do hereby authorize TRIO Upward Bound Staff to communicate with the participant via email, phone, text, other apps, and social media groups to receive updates, reminders, and other notifications related to program activities. 

Confirm*

Media Release

I do hereby authorize TRIO Upward Bound Program to use photographs and video of the participant in media and marketing materials, including but not limited to, brochures, fliers, websites, and social media. NOTE: Please do NOT confirm if you do not authorize use of photographs and video of participant for media and marketing purposes. 

Confirm*

Release Authorizations

I, the participant named above, fully agree to the School Records, Communication, and Media Releases above.

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Date*

Release Authorizations

I, the parent/guardian of the above-named participant, I understand the provisions of this document and agree to the School Records, Communication, and Media Releases above. 

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Date*

Participant Agreement Form

The Front Range Community College TRIO Upward Bound Program at Westminster High School is a year-round program that provides services during the academic year and summer. Our goal is to support program participants with successfully graduating from high school prepared for college coursework, transitioning, and completing a two or four year degree. All participants accepted into the program are subject to a 60-day preliminary period and must demonstrate their commitment to receiving support for the duration of the program. Program participant, please read, checkbox to confirm, and sign the following:

I understand that participating in the TRIO Upward Bound Program is an opportunity, and I am personally responsible for my progress and success in collaboration with the Program Staff.

Confirm*

I understand that TRIO Upward Bound is a college preparatory program, and my initial intent is to apply for, attend and graduate from college. 

Confirm*

I understand that participants uphold a high standard of behavior, and I will conduct myself in a responsible manner while on Westminster High School campus, Front Range Community College campus, and while involved in Upward Bound Program activities. 

Confirm*

I understand that in order for the TRIO Upward Bound Program and myself to maintain a successful relationship, I must agree to the following:

Confirm*
  • Respond promptly to all communication efforts received from TRIO Upward Bound Staff.
  • Notify Program Staff of any contact information changes (addresses, phone numbers, etc.).
  • Communicate with Program Staff if I am unable to attend any scheduled meeting, workshop, or activity.
  • Remain on track to meet my learning targets by completing assignments for each of my classes.
  • Attend scheduled Individual Coaching at least once a month. 
  • Attend programming as needed or recommended by Program Staff for homework completion, tutoring sessions, college and financial aid assistance.
  • Participate in at least one UB activity per week during academic year.  
  • Participate in summer activities and programming. 

I affirm that I acknowledge, understand, and agree to my commitments as a TRIO Upward Bound Program participant. I understand that failure to uphold my responsibilities may result in probation or dismissal from the Front Range Community College TRIO Upward Bound Program.

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Date*
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Date*

Code of Conduct

All TRIO Upward Bound (UB) participants are expected to uphold high standards as articulated below. 


ATTENDANCE - Students are expected to attend all mandatory UB sessions as scheduled. It is your responsibility to sign the attendance sheet when you arrive for activities and events. It is your responsibility to notify us of your absence for mandatory events. Call the UB staff at Doctor Paula Prentice: 720-446-8453, Ms. Kayla Prieto 720-772-6082, Doctor Marisol Enriquez: 720-515-2736 during the school year or during field trips as soon as possible if you cannot attend a scheduled session. These numbers are available 24 hours, 7 days a week with a voice-mail system that allows you to leave a message. 

DRESS CODE - While parents have the primary responsibility for determining appropriate dress/grooming for their children, it is necessary to establish guidelines of what will be permitted. Students participating in TRIO UB are required to adhere to program dress code. Participants should dress in a manner that prioritizes their safety and shows respect to themselves and the program. Please be advised that the following dress code will be enforced for all students:

  • During UB field trips, participants may be asked to wear particular clothing appropriate for scheduled activities and/or UB shirts provided by the program for identification purposes.  
  • Articles of clothing that display profanity, products, or slogans that promote tobacco, alcohol, drugs, sex or are in any other way distracting, divisive, or demeaning to others are prohibited.

RIGHTS OF PARTICIPANTS: 

  • Reasonable and timely notice of all rules, regulations, policies and penalties to which they may be subject
  • Physical safety and protection of their personal property
  • Consultation with teachers, administrators, counselors and other staff
  • Participation in UB without being subject to any form of discrimination
  • Respect from other students and staff
  • Present grievances to program staff and receive timely replies as to the disposition of the complaint

RESPONSIBILITIES OF PARTICIPANTS: 

  • Attend sessions as scheduled and be on time for all events
  • Follow directions of all staff employed with the college during all UB sponsored activities
  • Behave in a manner which does not interfere with the learning process of other students
  • Respect individuals and property and conduct him/herself in a responsible manner
  • Show respect for others and be sensitive to what may offend individuals from different backgrounds
  • Dress in accordance with UB standards of safety, health and good grooming
  • Obey all rules, regulations and policies
  • Seek assistance from staff if experiencing difficulties in school, home or personal life or with other participants
  • Communicate with program staff in advance regarding absences or concerns about meeting expectations
  • Be prepared for each session and respond to all communication attempts

ELECTRONIC DEVICES: - Limit the use of cell phones/texting to breaks or after program hours to show respect for teachers, guest speakers, as well as peers. Students found using their cell phones/ during class/sessions may have them confiscated for the day. 


AUTOMOBILES - If a student drives to Front Range Community College campus for UB Summer Academy or other events, the car must stay parked until program ends. Students may not use their cars to travel during UB field trips unless permission is granted for special circumstances. The UB Program cannot assume responsibility for accidents.

 

DATING - While attending UB activities, signs of affection (hugging, kissing, excessive touching, holding hands, etc.) are prohibited during program hours. They tend to interfere with a student’s ability to stay focused on their goals and objectives. Your primary focus while at UB should be on your education. 

BEHAVIOR - Students are to show respect to all UB staff, speakers, visitors and other students at all times. During field trips, if any of the following behaviors occurs, parents may be required to pick up participant immediately from field trip destination. The following behaviors may cause immediate termination or result in a behavior contract in order to continue as a UB participant:

  • Fighting
  • Arson
  • Theft
  • Defacing of Public/Private Property - such as graffiti, etc.
  • Multiple unexcused absences
  • Dangerous pranks, including, tampering with fire alarms or smoke detectors or causing injury to another person
  • Inappropriate sexual behavior or sexual harassment
  • Possession or use of any illegal drug or alcohol
  • Possession or use of fireworks/explosives
  • Possessing, smoking or using tobacco products
  • Publishing and distributing unauthorized materials
  • Cheating or lying
  • Throwing objects
  • Running in classrooms or science labs
  • Failure to comply with dress code
  • Loitering around campus
  • Foul language, obscene gestures, gang signing
  • Sleeping in class
  • Disturbance on bus or van
  • Unauthorized use of cell phones &/or other electronic device
  • Leaving college grounds or assigned space or dorm room without permission
  • Inappropriate bathroom behavior
  • Unauthorized use of college computer equipment
  • Harassing or taunting others
  • Littering
  • Extortion

I affirm that I acknowledge, understand, and agree to the Participant Code of Conduct during all TRIO Upward Bound activities. I understand that failure to uphold these expectations may result in probation or dismissal from the Front Range Community College TRIO Upward Bound Program.

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Date*

I am the parent/guardian of the above named participant. I understand the provisions of this document and agree to the TRIO Upward Bound Participant Code of Conduct. 

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Date*
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