Veterans Upward Bound Pre-Registration Form

Thank you for your interest in the Veterans Upward Bound program. Please complete the information below and someone from our staff will be contacting you.

Fields with asterisks (*) are required.

First name *

Last name *

Email *

Contact number *

Address Information

Address

City

State *

Zip Code *

County *

Veteran Status

Are you a veteran? *

Yes

Courses of Interest

Choice 1

Choice 2

Choice 3

How did you hear about us?

Source

By submitting this form, you are giving your express written consent for Wayne State University Veterans Upward Bound to contact you regarding our educational programs and services using email, telephone or text – including our use of automated technology for periodic texts to the wireless number you provide. Message and data rates may apply. The consent is not required to purchase goods or services and you may always call us directly or leave a voicemail at 313-577-9710.