|
Thank you for your interest in our Student Support Services program! Please complete this application as thoroughly as possible. You cannot save and restart this application. You may want to review the included items, take some time to make notes and gather the required documents, and then return to submit your application. If you have any questions, please call our office at (406) 496-4683.
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Please select the category/categories that best represents your racial identification and mark all others with a no.
|
Race, American Indian or Alaskan Native
*
|
|
Race, Black or African American
*
|
Race, Hawaiian or other Native to Pacific Island
*
|
|
|
|
|
Describe your primary reason for applying:
*
|
When did you first enroll at Montana Tech?
|
Declared Science, Technology, Engineering, or Mathematics (STEM) major.
|
Did you apply for and receive Financial Aid this year?
|
|
Are you a full or part time student?
*
|
|
How's your academic standing?
*
|
SSS services you might take advantage of? (Check all that apply)
|
|
Personal development workshops
|
|
|
|
|
|
Why might you utilize TRIO SSS services?(check all that apply)
|
Out of academics 5 or more years
|
Failing grades (H.S. or College)
|
|
Uncertain of academic preparedness
|
Need for academic support
|
Uncertain of career goals
|
Uncertain of educational goals
|
Limited English proficiency
|
|
High School Equivalency (GED)
|
|
|
Do you have a documented disability? (Physical/Learning/Emotional/Mental)
*
|
Are you currently registered with Tech's Disability Services for students?
*
|
Eligibility for Program Services
TRIO is a support program funded by the Federal government to ensure students who are the first in their families to attend college, have the resources and care needed to graduate.
We ask for access to your academic history and records in order to customize services to meet your needs, and federal reporting requirements.
|
|
Parents Educational Level:
*
|
How many people in your household at home?
*
|
Family Taxable Income Range:
*
|
|
|
|
Please select a signature verification type.
|
Terms of Submission:
I certify that the information on this application is accurate and complete to the best of my knowledge.Â
 I hereby authorize the Student Support Services program to obtain any information from my educational records (e.g., transcripts, entrance test scores, grades, instructor contacts, etc.) and to perform staffing activities that may be pertinent to my participation in this project.Â
 I also agree that, if I am selected to participate in the TRIO SSS project, I will work with my staff advisor to develop and implement an individual Education Assessment Plan.
|
|