TRIO SSS PROGRAM ELIGIBILITY



LAST NAME: *
FIRST NAME: *
SCHOOL ID 820: *
PARENT(S) EDUCATIONAL INFORMATION
Did your MOTHER graduate from college with a 4-year degree? * NO YES
Did your FATHER graduate from college with a 4-year degree? * NO YES
If YES to either, with which parent do you live? * Mother Father Both Neither
HOUSEHOLD INCOME INFORMATION The following link details the low income levels for TRIO Programs: https://www2.ed.gov/about/offices/list/ope/trio/incomelevels.html (Copy and paste link in website browser to view information).
Number of people living in your household (including yourself)? *
What is your parent(s) Annual Taxable Income* for the previous year? *
PLEASE NOTE: Taxable Income is usually lower than Adjustable Gross Income which is located at the bottom of the first page on most tax return form. Annual Taxable Income can be found on page 2 of most tax return forms.
If your parent(s) did not file tax returns for previous year, please enter amount of family income for the year:
If you are 24 years old or independent and not claimed on parent(s) tax returns, please enter amount of family income for the previous year:
The signatures below certify that all the Education Level and Household Information provided on this form by my parent(s) and me is correct and true to the best of our knowledge.
PARENT/GUARDIAN'S E-SIGNATURE
Please click Simple and use your mouse to sign the application: * Please select a signature verification type.
STUDENT'S E-SIGNATURE
Please click Simple and use your mouse to sign the application: * Please select a signature verification type.

LAST NAME: *

FIRST NAME: *

SCHOOL ID 820: *

PARENT(S) EDUCATIONAL INFORMATION

Did your MOTHER graduate from college with a 4-year degree? *

Did your FATHER graduate from college with a 4-year degree? *

If YES to either, with which parent do you live? *

HOUSEHOLD INCOME INFORMATION

The following link details the low income levels for TRIO Programs: https://www2.ed.gov/about/offices/list/ope/trio/incomelevels.html (Copy and paste link in website browser to view information).

Number of people living in your household (including yourself)? *

What is your parent(s) Annual Taxable Income* for the previous year? *

PLEASE NOTE: Taxable Income is usually lower than Adjustable Gross Income which is located at the bottom of the first page on most tax return form. Annual Taxable Income can be found on page 2 of most tax return forms.

If your parent(s) did not file tax returns for previous year, please enter amount of family income for the year:

If you are 24 years old or independent and not claimed on parent(s) tax returns, please enter amount of family income for the previous year:

The signatures below certify that all the Education Level and Household Information provided on this form by my parent(s) and me is correct and true to the best of our knowledge.

PARENT/GUARDIAN'S E-SIGNATURE

Please click Simple and use your mouse to sign the application: *

Please select a signature verification type.

STUDENT'S E-SIGNATURE

Please click Simple and use your mouse to sign the application: *

Please select a signature verification type.