Veterans Upward Bound Program Inquiry Form

Thank you for your interest in the EKU Veterans Upward Bound Program!

Please answer the following questions with regard to you residence and Veteran status. If you have any questions, please email VUB Director, Holly Branscum.

Veteran Information

First Name

Last Name

Email Address

Phone Number

Birthdate

County of Residence

Are you a first-generation college student* and/or did you start college but earned less than 60 college credits?
*Neither parent received a 4-year degree prior to you turning 18

Branch of Service

Have you served for more than 180 consecutive days on active duty?

Were you issued a DD 214 and a discharge other than dishonorable?

Number of people living in household (enter "1" if only yourself)

Taxable Household Income:

Do you have a disability?

Yes

Pending

Preferred method of contact