The Wesleyan University Upward Bound Math-Science (UBMS) program is designed to aid low-income and/or first-generation students from Middletown and attending Middletown High School. The UBMS programs are federally funded by the U.S Department of Education and is free to participants. Below is the application for the UBMS program.

The application has three sections; Student demographics and a student questionnaire followed by Parent/Guardian demographics and taxable income information, Please complete the questions as best and thoroughly as you can. Parent/Guardian must allow the UBMS programs access to their child's educational records order to for the program to determine academic eligibility. A completed application consists of the completed questions AND signatures.

The program will request the most recent copies of 1040 tax forms or other forms of income verification, along with other verifying documents, in order to determine eligibility. The UBMS staff will reach out to conduct an interview with the student applicant and parent/guardian(s), if the applicant is found to be eligible after review of application. Please do not hesitate to reach out with any questions or concerns by emailing jromine@wesleyan.edu.

What is student's (applicant) gender?
Student's (applicant) Race/Ethnicity (Select all that apply)
Student's (applicant) Citizenship Status
Student's (applicant) Current Grade
Student's (applicant) School Attending (or will attend in 9th grade)
  •
Does the student (applicant) have a physical disability which might require an environmental accommodation or a diagnosed learning disability? 
Student Questionnaire
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Does the student's BIOLOGICAL mother have a bachelor's degree (4-year college degree) or beyond?
Does the student's BIOLOGICAL father have a bachelor's degree (4-year college degree) or beyond?
Does the student's (applicant) family receive any of the following benefits? (Select all that apply)
With whom does student (applicant) live with?