Student's Last Name:
Second Phone Number:
Is the student a US Citizen or Permanent Resident?
Student's Academic plans after high school?
How did you hear about the UB program?
Your School Staff/Faculty
Does any of the student's parents/guardians have a Bachelors degree?
What grade is the student in now?
What school does the student attend?
What kind of grades does the student usually receive?
Mostly As and Bs
Mostly Bs and Cs
Mostly Cs and Fs
I am a:
If you are not a student please enter your Name/Title:
What kind of information are you requesting?
UB Application Packet
Both a UB Brochure and Application Packet
Questions or comments
If you have any questions or comments email