Trio-SSS Application

Select a date from the calendar.


What is the highest level of education achieved by your parent or guardian? If your parents are/were divorced and you resided with them until you were 18, reply only in regards to the parent who had primary custody:

Dependency Status:(If you answered “no” to all four questions, you may be considered dependent status. If you answered “yes” to at least 1 question, you are likely considered independent status.)

The above information is true and complete, to my knowledge. I understand it is confidential and will be used for intake purposes. Further, I release the following information to TRIO-Student Support Services to verify eligibility, determine appropriate services, and to track academic progress: mid-term and final grades, transcripts/registration information, financial aid information, standardized test scores (ACT/SAT/COMPASS/ACCUPLACER, etc.), income information, transfer information, and contact instructors/advisors. Providing my cell phone number enrolls me in the texting program that I can opt out of at any time, TRIO nor SRC are responsible for any texting charges. I understand completion of application does not guarantee acceptance to the SRC TRIO-SSS program. I understand the TRIO Director reserves the right to admit or deny any student’s acceptance to the SRC TRIO-SSS program. Students are accepted into the program on a first come, first serve basis and is based on eligibility criteria outlined by the Department of Education that funds the program.
Electronic Signature:

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