APPLICATION

 TRiO Student Support Services

Northeast State Community College

We sincerely thank you for your interest in TRiO!

We are happy you are applying and we look forward to reviewing your application!

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All information on this application is kept strictly confidential.

  • Applications are reviewed on a first-come, first-serve basis. 
  • Offer to move forward with the application process is based on eligibility criteria and the ability to demonstrate academic potential and motivation.
  • TRiO serves 180 students each year.
  • Applying to the program does not guarantee acceptance.
  • Incomplete applications will not be considered.

PLEASE NOTE:

  • Students applying to TRiO must be a U.S. Citizen or U.S. Permanent Resident to qualify for consideration of TRiO services.

  • Students who have already earned a 4-year Bachelor's Degree are ineligible to apply to TRiO due to having proven success in earning a college degree.

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STUDENT INFORMATION
First Name *
Middle Name *
Last Name *
Date of Birth *
Student ID Number (Your student ID number is a unique nine-digit identifier assigned to you when you apply to Northeast State. It is highly recommended you memorize this number.) *
Mailing Address *
City *
Permanent State *
Zip *
Home Phone (if no home phone, put a series of zeros) *
Cell Phone Number (if no cell phone, put a series of zeros) *
Do you agree to receive text messages at the cell number listed above? *
Email Address *

CAMPUS INFORMATION

At which Northeast State campus do you spend most of your time taking classes? *

EDUCATION

PLEASE NOTE:

Students who have already earned a 4-year Bachelor's Degree are ineligible to apply to TRiO due to having proven success in earning a college degree. If answer "Yes"  the question below about having earned a 4-year Bachelor's Degree, please close the application and contact TRiO to request information about resources available on campus.

Earned a 4-year Bachelor's Degree? *
Educational plans at NeSCC? *
Your major? *
Type of degree seeking at NeSCC? *

ETHNICITY

American Indian or Alaskan Native *
Asian *
Black or African American *
Hawaiian or other Native to Pacific Island *
Hispanic *
White *

GENDER

Gender *

CITIZENSHIP

Citizenship *

FINANCIAL AID

Have you applied for financial aid? *
If you have applied for Financial Aid, what is your eligibility status? *

SERVICES REQUEST

Academic Advising
Career Readiness
Counseling Resources
ESL Resources
Financial Literacy/Financial Planning
Mentoring
Transfer Advising
Trips: College Visits/Cultural Events
Tutoring
Use of TRiO Tutor Lab

FIRST-GENERATION CRITERIA 

Please select one: *

DISABILITY CRITERIA 

Do you have a documented disability? *
If yes to documented disability, are you registered with Accessibility Services at Northeast State (formerly the Center for Students with Disabilities)? *

INDEPENDENT STUDENT STATUS   (Check all that apply as defined by FAFSA)  

If NO items are selected from the list below, your parent or guardian must sign a Guardian/Income Form. TRiO will email the form to your Parent/Guardian. Please make your Parent/Guardian aware that TRiO will be sending an email to them. Thank you.

At least 24 years old
A parent
An orphan or ward of the court
A veteran
Married
Have a 4-year Bachelor's Degree
Select statement that is true: *

GUARDIAN INFORMATION   If you are a DEPENDENT STUDENT, please enter Guardian information below and please inform your Guardian to be checking their email for a TRiO Guardian/Income Verification Form. Until the Guardian/Income Form is received, your TRiO Application will be on hold.

Guardian Name
Guardian E-Mail
Guardian Phone Number

INCOME CRITERIA   The U.S. Department of Education requires that NeSCC TRiO Student Support Services obtain information regarding your income. This information is used for determining program eligibility and for statistical purposes in our annual reports. It is kept strictly confidential.

Number of people living in your household, including yourself, during 2020. (If you are a DEPENDENT STUDENT, please respond to this question with NA.) *
  • The best source for income information is your 2020 Federal Tax Return.
  • Taxable income is reported on line 15 of form 1040 or 1040-SR.
  • It is very important that you indicate TAXABLE income and not total income or adjusted gross income.
  • If NO taxable household income OR did not file please put zero (0) below in Amount of your taxable household income.
Amount of 2020 TAXABLE income. (If you are a DEPENDENT STUDENT, please respond to this question with NA.) *
Please select statement that is true. *

YOUR GOALS 

Please share with us why you are in college. For example: What motivated you to go to college? How will a college degree/certificate change your life? Where do you see yourself three years from now? *

SIGNATURE   By typing your FIRST NAME and LAST NAME below, you certify that the information on this application is true to the best of your knowledge. Typing your name is the equivalent of a digital signature.

***IMPORTANT***

Steps for your Electronic Signature and Submit Application:

  1. Type your full name in the text box below.
  2. Click the check box next to “I agree to the terms included.”
  3. Click Sign and Submit Signature
  4. Signature Accepted notification will appear.
  5. Click on Submit Application
*
Signature Type: Simple    Start Over
Signature: (Type in your full name)
I agree to the terms included.