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• Scholar information
• Parents/Guardians information and signatures
• Income information
• School counselor’s contact information
• Medical Information

• If you are not a citizen but are residing in the U.S. with other documentation please specify (for example: permanent resident/green card holder, visa holder).
• Important Note: Only the student’s documentation status is required. All information collected in the application form is kept confidential and used for GEAR UP College Bound staff purposes only.

If a student does not have a phone, they should give parent or guardian’s phone number where they can be reached, or put N/A.

Students must not provide a “@jcpsnj.org” email. A personal email should be used. If the student does not have another email, please provide a parent/guardian’s email or enter N/A.

Under “Current Employer,” enter self-employed and list your number.

• This refers to the total earned and/or unearned income of your household before taxes were applied.
• For most, this information can be obtained from the most recent individual tax returns (Form 1040, line 15).
• If you do not have a tax return or access to your Total Taxable Household Income, please indicate the nature of your situation by stating: N/A, tax exempt, receives government assistance, etc.

If you do not know what to put for any of the questions, please enter “N/A” so that you can continue to complete the application.

For additional assistance please contact the GEAR UP College Bound Program directly.

Phone: 201-200-2347
Email: njcuprecollege@gmail.com