Upgrade San Antonio Intake Form

Upgrade is a new regional collaborative in San Antonio focused on supporting adults who have some college credit and have not yet finished a degree or certificate. If you are an adult with some college credits, and you want to go back to finish your certificate, associate, or bachelor degree, Upgrade is here to help you explore your options.

Please fill out as many of the questions below as possible so that we can serve you better, faster, and more effectively. Remember: our services are always FREE. We will NEVER sell or give away your information. This form may take you 5-10 minutes to complete, but it will allow us to immediately tailor advising services to you and other opportunities.

Once we receive your form, we will contact you within 48 business hours via your preferred method of contact.

We look forward to assisting you!

When do you want to start classes?

How quickly would you like to graduate?

How Did You Hear About Us?

What information are you interested in?

First Name

Middle Name

Last Name

Suffix

Your email will be used to contact you for advising. You will also receive occasional newsletters, information about opportunities for Comebackers like you and requests to update your information in our records. You will always receive opt-out options for all.

Home Phone

Mobile Phone

Preferred Phone

HomeWorkMobileOther

Street Address

City

State

Zip Code

City Council District

Preferred Contact Method

PhoneEmailPhone or Email

What is your employment status?

Employed - 0 to 20 hours per week on averageEmployed - 20 to 40 hours per week on averageEmployed - 40+ hours per week on averageNot employed but lookingNot employed, not looking

Does your employer offer tuition benefits?

YesNoNot Sure

Current Job Title

Company

If your employer is partnering with Upgrade, please indicate City of San Antonio or Bexar County.

The following information is considered confidential by many people. We are concerned with your privacy as well. Please know that this information is used only in aggregate, for fund-raising purposes, so that we may continue to provided our services for free. We appreciate your support as you consider providing the requested information.

Categories

Date of Birth

mm/dd/yyyy

Gender You Identify With

MaleFemaleAlternative or Other

Are you a parent?

YesNo

If so, what are the ages of your children? (separate ages with commas)

Family Annual Income

Please tell us a little about your educational experience.

What is the highest level of education you have completed?

What kept you from finishing college?

Do you currently have defaulted student loans?

YesNoNot Sure

Have you served in the US Armed Forces?

YesNo

Please provide some information about your educational goals.

What type of degree are you seeking?

Preferred Class format

Academic Area of Interest

What is your main reason for returning to college now?

By submitting this form I give permission to Upgrade San Antonio to forward my information to its partner institutions for purposes of assisting with my college admissions/enrollment.

I give permission to the Admissions/Office of Enrollment Management/Registrar of the College/University I shall be attending to release to Upgrade San Antonio information verifying my enrollment status and my official transcript.

I fully understand that all information given on this application and information released to Upgrade San Antonio or its partner institutions is protected by the Federal Privacy Act and, therefore will be kept confidential. Upgrade San Antonio promises it will NEVER sell or give away personal information.

I certify that all information that I have provided on this application is accurate and true to the best of my knowledge and ability.

If you have questions now or later, please contact Micaela Rios at mrios@saedpartnership.org .