TRiO 学生支援服务 Application "*表示必填字段 个人信息What campus will you be attending classes?* 红木 卡姆登 名字* 第一个 中间的初始 最后的 街道地址* 公寓# 城市* 状态*阿拉巴马州阿拉斯加亚利桑那州阿肯色州加州科罗拉多州康涅狄格特拉华州哥伦比亚特区佛罗里达乔治亚州夏威夷爱达荷州伊利诺斯州印第安纳州爱荷华州堪萨斯肯塔基州路易斯安那州缅因州马里兰麻萨诸塞州密歇根明尼苏达州密西西比州密苏里州蒙大拿内布拉斯加州内华达新汉普郡新泽西新墨西哥纽约北卡罗莱纳北达科他俄亥俄州俄克拉何马州俄勒冈州宾西法尼亚罗德岛州南卡罗来纳南达科塔州田纳西州德州犹他州佛蒙特州维吉尼亚州华盛顿西维吉尼亚州威斯康辛州怀俄明美洲武装部队欧洲武装力量太平洋武装部队邮政编码* 学生的电子邮件* 家庭电话手机*社会保障#* 学生证* 性别* 男性 女 生日* 年龄 公民ship / Ethnic / Racial Group你是美国人吗?.S. 公民?* 是的 No 婚姻状况* 单 结婚了 分离 离婚了 丧偶的 如果你不是美国人.S. 公民, are you a Permanent Resident?* 是的 No Enter Permanent Resident Alien Number Please check race group which you think best applies to you.* American Indian/阿拉斯加 Native 亚洲 黑人或非裔美国人 Native 夏威夷an/Pacific Islander 白色 超过一场比赛 种族未知 其他 我不想透露 你是西班牙裔还是拉丁裔?* 是的 No Have you ever participated in another TRIO program? (检查所有适用的.) 向上的束缚 人才搜索 转换端 瑞士 麦克奈尔的学者 Are you a part of the 教育al Opportunity Fund (EOF) Program?* 是的 No 教育Have you or will you graduate from high school?* 是的 No 你获得普通教育水平证书了吗?* 是的 No 你获得GED证书的年份* What High School did/will you graduate from?* Previous College(s) Attended When did you begin coursework at 全球赌博十大网站?* 秋天 春天 夏天 一年* When do you expect to graduate?* 秋天 春天 夏天 一年* What is your current classification?* 大一新生 二年级学生 你目前的平均绩点是多少?* 注册状态?* 全职 兼职 个小时了* 你主修什么专业??* Did either of your parents or legal guardian earn a Bachelor’s degree before your 18th birthday? 是的 No 谁有学士学位?* 妈妈。 父亲 这两个 Have you ever been in foster care or in a court appointed guardianship?* 是的 No If yes, were you in foster care after the 年龄 of 13 years-old?* 是的 No Check all the services you would benefit from 学术顾问 职业发展 领导力发展 金融教育 转让通知 辅导 财务信息What is the total number of persons in your family?*Did you or your parent(s) file taxes last year?* 是的 No Check the range that includes your household income for last year* $0 - $21,870 $21,871 - $29,580 $29,581 - $37,290 $37,291 - $45,000 $45,001 - $52,710 $52,711 - $60,420 $60,421 – $68,130 $68,131 - $75,840 超过75841美元 I certify that the information entered here in this section is true and correct to the best of my knowledge.*日期* 学生合同It is expected that each student participating in the program will be dedicated to academic excellence. 我签名表示同意 致: Meet with my Success Coach a minimum of two times during the semester (at least once in person). Attend a minimum of one Student Success Workshop, 瑞士 activity and/or cultural educational activity per semester. If I am on academic probation or receive an early alert, I agree to contact 瑞士 to set up an academic plan of action. I agree to work towards achieving the goals outlined in my Individual Academic Plan (IAP) Comply with all rules and guidelines in order to remain eligible in the 瑞士 program provided by College. 学生同意I authorize Student Success Programs staff to access any records required in assisting me including, 但不限于: 残疾人服务 Registrar’s Office/Student Records 财政援助办事处 教师 members regarding academic progress I agree to have my photo used to promote the program. (note: acceptance is not contingent upon agreement) I certify that the information included on this application is true and correct to the best of my knowledge. If additional documentation is required, I agree to submit required documentation in a timely manner. I understand that if found that I have intentionally misrepresented myself, it is sufficient cause for dismissal from the 学生支援服务 Program.Opt in for TRIO 瑞士 text mess年龄 program alerts. The text mess年龄s are only related to TRIO 瑞士 program information. If yes, please add phone number. 签名*日期* 验证码电话This field is for validation purposes and should be left unchanged.