EOC Application

TRiO Educational Opportunity Center Application
Today's Date:*

MonthDayYear
Date
Name:*

First NameMiddle InitialLast Name
Date of Birth:*

MonthDayYear
Date
Age:*
Gender:*
Mailing Address*
City*
State*
Zip Code*
Email Address*
Telephone Number*
Please enter a valid phone number.
Are you a current participant of an Upward Bound or Talent Search program?*

YesNo
Is English your first language?*

YesNo
Are you a U.S. Citizen or a Permanent Resident?*

YesNo
Please select your race (For Reporting Purposes Only):*

Hispanic or LatinoAmerican Indian or Alaska NativeAsianNative Hawaiian or Other Pacific IslanderCaucasian or WhiteBlack or African-American
Military Connected Status:

VeteranActive DutyDependent Child of Active DutyDependent Spouse of Active Duty
What is your current marital status?*

SingleMarriedDivorcedSeparatedWidowed
Are you or have you been

HomelessIn or aging out of foster care or legal guardianship
Are you providing more than 50% support for any children or dependents?*

YesNo
How many family members live in your household?*
Family’s taxable income level (Line 15 of tax return form 1040):*

Option 1: 0 - $23,475Option 2: $23,476 - $31,725Option 3: $31,726 - $39,975Option 4: $39,976 - $48,225Option 5: $48,226 - $56,475Option 6: $56,476 - $64,725Option 7: $64,726 - $72,975Option 8: $72,976 - $81,225Option 9: Above $81,225
Did either of your parents (biological, step, or adoptive) graduate from a 4-year college?*

YesNo
Please indicate your current level of education below (choose one):*

Completed a 4-year college degreeCompleted a 2-year college degreeCurrently enrolled in college or technical schoolAttended college or tech school but did not completeHigh School or GED graduateCurrently a high school SeniorCurrently enrolled in GEDDid not complete High School, not in GED
Which high school do you attend?
How can we help you today? (mark all that apply)*

Assistance with the FAFSA or other financial aid assistanceAssistance applying to college or technical schoolAssistance finding a college or technical school programAssistance with academic test prepAssistance finding my career interestsAssistance with financial literacyAssistance finding a GED/HiSet programAssistance finding other resources
Acknowledgement

My signature below certifies that the above information is correct. It also serves as consent for my records (transcripts, financial aid awards and information, test scores, as well as any information provided to National Student Clearinghouse) to be released to the Federal TRIO program(s) that I am a member of (Educational Opportunity Center) from Carl Albert State College for the specific purposes of tracking which allows the Federal TRIO programs to follow my college career. I understand that this is information that is required for their grants and I am consenting that such information be shared with them.l understand that EOC will contact me upon receipt of my application to obtain additional information and/or provide services and resources including financial literacy information.Regarding FAFSA Assistance: I also acknowledge that although EOC provides FAFSA assistance, the program is not part of the financial. aid office at my institution Therefore it is my responsibility to adhere to FAFSA guidelines. This includes providing accurate and complete information on the FAFSA application. I understand EOC is not responsible or liable for required information that is reported incorrectly or undisclosed. Once the FAFSA has been completed it is also my responsibility to follow up with my institution to complete additional forms to complete the financial aid process.
Signature: Click here to sign*
Parent/Guardian Signature: Click here to sign Date
Should be Empty:

TRiO Educational Opportunity Center Application