TRiO Educational Opportunity Center Application
Today's Date:
*
/
Month
/
Day
Year
Date
Name:
*
First Name
Middle Initial
Last Name
Date of Birth:
*
-
Month
-
Day
Year
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?
*
Yes
No
Is English your first language?
*
Yes
No
Are you a U.S. Citizen or a Permanent Resident?
*
Yes
No
Please select your race (For Reporting Purposes Only):
*
Hispanic or Latino
American Indian or Alaska Native
Asian
Native Hawaiian or Other Pacific Islander
Caucasian or White
Black or African-American
Military Connected Status:
Veteran
Active Duty
Dependent Child of Active Duty
Dependent Spouse of Active Duty
What is your current marital status?
*
Single
Married
Divorced
Separated
Widowed
Are you or have you been
Homeless
In or aging out of foster care or legal guardianship
Are you providing more than 50% support for any children or dependents?
*
Yes
No
How many family members live in your household?
*
What is your family's taxable income level?
*
Option 1: 0 - $22,590
Option 2: $22,591 - $30,660
Option 3: $30,661 - $38,730
Option 4: $38,731 - $46,800
Option 5: $46,801 - $54,870
Option 6: $54,871 - $62,940
Option 7: $62,941 - $71,010
Option 8: $71,011 - $79,080
Option 9: Above $79,081
Did either of your parents (biological, step, or adoptive) graduate from a 4-year college?
*
Yes
No
Please indicate your current level of education below (choose one):
*
Completed a 4-year college degree
Completed a 2-year college degree
Currently enrolled in college or technical school
Attended college or tech school but did not complete
High School or GED graduate
Currently a high school Senior
Currently enrolled in GED
Did not complete High School, not in GED
How can we help you today? (mark all that apply)
*
Assistance with the FAFSA or other financial aid assistance
Assistance applying to college or technical school
Assistance finding a college or technical school program
Assistance with academic test prep
Assistance finding my career interests
Assistance with financial literacy
Assistance finding a GED/HiSet program
Assistance 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
Submit
Should be Empty: