Request to be Excused from UB Activity Form

Participating in Upward Bound activities is an important part of being a UB Scholar. If a situation or circumstance will prevent you from attending a UB activity, simply fill out this short form and your request will be reviewed.

Please make sure you fill out the form completely.

First Name Last Name

Which high school do you attend?

Your email address

Which UB activity do you need to be excused from?

Describe your situation or circumstance. Please be specific.

Center for Educational Partnerships
 5171 California Ave., Suite 150
Irvine, CA 92697-2505