APPLICATION FOR STUDENT SUPPORT SERVICES ADMISSION TEXAS CHRISTIAN UNIVERSITY TCU BOX 297760 FORT WORTH, TX 76129 (817)257-7946

MISSION The Student Support Services Program provides opportunities for academic development, assistance with university course requirements, and motivation towards successful completion of post-secondary education. The purpose of the SSS Program is to increase the college retention and graduation rates of the students we serve.

SERVICES AVAILABLE • • • • • • • • • •

Individual and small group tutoring Collaboration with math and writing labs Financial aid advisement and research for additional resources Financial Literacy Educational Workshops Cultural, social enrichment, and educational activities Personal counseling and Academic Advising provided by staff Peer mentoring services and activities Career exploration and decision-making Study lab with updated technological resources Graduate School Assistance

According to federal regulations, the TCU SSS Program can serve only 160 students annually, so spaces are limited. It is strongly suggested that applications adhere to the following application deadlines. APPLICATION PRIORITY DATE FOR FALL SEMESTER IS 9/30, SPRING 2/28.

DETAILS OF SERVICES Academic Assistance: SSS provides academic assistance to students in areas such as individual and small group tutoring, review classes in math, science, English/writing and other subjects. SSS also assists with study skills, reading skills, and educational assessments. Financial Assistance: SSS assists students in securing the most appropriate financial resources through individual counseling, program resources, referral liaison with the TCU Office of Scholarships and Student Financial Aid, community financial support agencies, and grant award opportunities. Personal Assistance: SSS provides motivation and personal support to program participants through counseling, peer advisement, and referrals to the Counseling Center or appropriate community based agencies. Social and Cultural Assistance: SSS sponsors a variety of social awareness and cultural enrichment activities, as well as other cultural programs and access to special interest groups from the campus community.

ELIGIBILITY Federal regulations determine eligibility for Student Support Services. Student and advisor establish academic needs. The student must qualify under one or more of the following categories: • First-generation college student • Financially disadvantaged • Registered disability A first generation college student means that neither parent has received a bachelor’s degree from an accredited college or university. Financially disadvantaged students meet income requirements determined by federal guidelines. Student with disabilities are referred by the Student Disabilities Services.

COST There is no cost to the student. The United States Department of Education and TCU cover all costs.

APPLICATION FOR SSS To be considered for acceptance to the program, you must complete and return an application by the deadline date. To complete the processes of your application, please provide us with the following required documents:

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Application form completed

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A copy of parent/guardian’s latest Income Tax Form 1040 or Student Aid Report (SAR) found at FAFSA.gov

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A copy of College Transcript for transfer students

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A copy of your Current Class Schedule

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A copy of your Financial Aid Summary/Award Letter

_____

Proof of Residency requirement if you are not a US citizen, please furnish a copy of alien registration card

_____ If applicable, a copy of certification of disability (Verification through the Student Disabilities Services)

____________________________________

____________________________________

Student’s Signature

Date

STUDENT SUPPORT SERVICES TEXAS CHRISTIAN UNIVERSITY

OFFICE USE ONLY

STUDENT APPLICATION Program Expectations The TRiO/SSS program staff wants students who are motivated to make full use of TRiO/SSS services to become a successful Texas Christian University graduate. It is expected that program participants meet with their TRiO/SSS advisor or engage in other activities a minimum of once per month. TRiO/SSS is not a scholarship program; however, a limited number of students may qualify and receive a program-based scholarship contingent on actual funding.

PERSONAL DATA: Name: _____________________________________________________ First

MI

Last

TCU ID: __________________________________________

Date of Review: _____________ Currently Enrolled? □ Yes □ No □ Part Time □ Full Time Term: ______________________ Income Verified? □ Yes □ No Major: _____________________ Advising? □Yes □ No Classification: □ FR □ SO □ JR □ SR FINANCIAL AID Family’s Verified Taxable Income $ __________________________ Family Size: _________________ Need: ______________________ Award: _____________________

Social Security No.: __________ - __________ - __________ □ □

How did you receive this application? □ Received in mail □ TCU SSS office □

TCU SSS webpage Other TRiO program

Referred by:_________________________________________

ACADEMICS Previous school: __________________________ Incoming GPA: Grad YR: ________________

Local/Campus Address: _____________________________________________ City: ________________________ State: ___________ Zip: _______________ Cell Phone: ______________________ Other Phone: _____________________ Email: ___________________________________________________________ Home Address: ___________________________________________________ City: ________________________ State: __________ Zip: ________________ Home Phone: _______________________ Gender: __________ Birthdate: ________ / ________ / ________ □ Resident Alien (enclose copy of card) Citizenship Status: □ US Citizen □ Other: ______________________________________________ Ethnic Origin: □ Caucasian/White □ American Indian/Alaskan Native □ Hispanic □ Asian/Pacific Islander □ African American □ Other: ____________________

Marital Status: □ Married □ Single □ Separated □ Divorced Children? □ Yes □ No Ages: ________________________ Veteran?

□ Yes

□ No

Military Branch: ________________________

Active/ Military Reservist? □ Yes

□ No

Branch: __________________

ELIGIBILITY DECISION 1) Income Eligible? □Yes □No 2) First Generation? □Yes □No 3) Disabled? □Yes □No 4) Academic Need? □Yes □No 5) Enrolled FT? □Yes □No 6) Veteran? □Yes □No 7) Transfer? □Yes □No 8) TRiO Alumni? □Yes □No □Accepted □Denied □Waitlisted Entry Date: _________________ Comments: _________________ ___________________________ ___________________________ COMMENTS ___________________________ ___________________________ Verification ___________________________ Director’s Signature

TCU Box 297760 ● Fort Worth, TX 76129 ● Phone: (817) 257 - 7946 ● Fax: (817) 257 - 7467

EDUCATIONAL DATA: High School: _____________________________________ Graduation Year/GED Received: ________________ Have you attended any other colleges or universities? □Yes □No If yes, please list colleges/universities and dates of attendance. (Student Signature) (Date) ____________________________________________________________________________________________ ____________________________________________________________________________________________ How many credits are you transferring? ______________________ Have you previously participated in any of the following TRiO programs? (Check all that apply.) □Upward Bound □Upward Bound Math/Science □Talent Search □Veterans Upward Bound (Parent/Guardian (Date) □Educational OpportunitySignature) Center □Student Support Services If so, with what colleges, universities, programs, or agencies were the programs affiliated? ____________________________________________________________________________________

ELIGIBILITY DATA: Have you been admitted to TCU? □Yes □No Are you currently enrolled in classes at TCU? □Yes □No Please indicate the first semester you attended/will attend TCU. _____________________ What is/will be your current college classification? □Freshman □Sophomore □Junior □Senior What is/will be your major? ____________________________ Have you applied for Financial Aid through the FAFSA form? □Yes □No Have you been awarded Financial Aid at TCU? □Yes □No Are you registered with TCU’s Student Disabilities Services? □Yes □No If yes, I give TCU Student Support Services permission to exchange information with TCU’s Center for Academic Services Disabilities Services and to keep documentation of my registration on file. ________________________________________ Student Signature

Indicate with whom you reside and their names. □Both Parents ________________________________________ □Mother _____________________________________________ □Father _____________________________________________ □Other ______________________________________________ Has either parent/guardian graduated from a four-year college/university? □Yes □No Please indicate the highest level of education for your parent or guardian. (i.e. grade school, HS, college) Mother_______ Year of Graduation______ Institution_______________________ Degree____________ Father_______ Year of Graduation_______ Institution_______________________ Degree____________ Other________ Year of Graduation______ Institution_______________________ Degree____________

TCU Box 297760 ● Fort Worth, TX 76129 ● Phone: (817) 257 - 7946 ● Fax: (817) 257 - 7467

CONSENT FOR RELEASE OF INFORMATION

I, ______________________________________, authorize Student Support Services (SSS) to gather information concerning my academic progress (standardized test scores, grade point average, earned credits, transcripts) and financial aid status prior to my participation in SSS. I understand the program uses this information to assist in the determination of my eligibility for SSS and it will be kept strictly confidential. I grant permission for SSS to gather information for follow-up whenever appropriate. I am aware my eligibility and financial aid status will be reported to the U.S. Department of Education in accordance with the grant funding regulations. I certify the information provided on this application is true and complete to the best of my knowledge. I also agree to provide documentation upon request to verify the information reported. I am also aware that Student Support Services, under the Family Education Rights Privacy Act of 1974, will protect the personal information I provide. No persons will have access to the information unless he or she works with or for the SSS Program, or are specifically authorized by the student to see the information. In addition, I verify the information provided in this application is true and accurate.

(Student Signature)

(Date)

PHOTO/MEDIA RELEASE Much of our publication and marketing success is from the use of photos and videos taken of TRiO/SSS students during program events. By signing below, you give the irrevocable right to use your name, photo, or video in all forms and media in all manners, including composite or distorted representations, for advertising, trade, or any other lawful purposes, and you waive any right to inspect or approve the finished version(s), including written copy that may be created in connection therewith. I verify I am at least 18 years of age, I have read this release and am fully familiar with the contents.

(Student Signature)

(Date)

*I am the parent or guardian of the minor named above and have the legal authority to execute the above release. I approve the aforementioned and waive any rights in the premises.

(Parent/Guardian Signature)

(Date)

TCU Box 297760 ● Fort Worth, TX 76129 ● Phone: (817) 257 - 7946 ● Fax: (817) 257 - 7467

STUDENT SUPPORT SERVICES PARTICIPANT GUIDELINES

Welcome Participants are advised to use SSS services throughout their stay at TCU and are encouraged to keep in touch after graduation. Signatures Your signature is very important to us. SSS is a TRiO program funded by the U.S. Department of Education. In order to maintain funding, it is very important to sign in every time you visit us and utilize the computer lab. Academic Development - Tutoring Attendance - Attending each scheduled session is mandatory. Sessions are 50 minutes long. Tutors are instructed to utilize students’ notes and/or textbooks during the sessions. Discuss any needed schedule changes with the tutor coordinator and counselor. Absences - A 24 hour advance notice is required. If you must cancel a tutoring session, call the office to notify the SSS tutor coordinator. You will be dropped from tutoring if you have more than two absences. Any extenuating circumstances must be discussed with the tutor coordinator. Counselor Appointments All students are expected to meet with their SSS counselor at least 2 - 4 times every semester after the Eligibility Interview. Students may schedule more appointments with their counselor as needed. Peer Mentor Appointments and Study Skills Assistance Students are encouraged to schedule appointments with an SSS Ambassador/Tutor for assistance with pursuing their academic goals here at TCU. Personal Development Student Support Services students are asked to attend SSS workshops, university workshops, or view and complete DVD workshops provided to you by the SSS counselor. Check your SSS calendar for the workshop schedule. Student Engagement University and community service involvement is encouraged along with attendance of various cultural conferences and banquets. Other Expectations All students are expected to strive toward success. It is therefore expected that all of our students: -Take at least 12 hours of course work if attending full time -Attend all of their classes -Work on weekly assignments -Engage with faculty -And, most importantly, graduate on time

(Print Student’s Name)

(Student’s Signature)

(Date)

TCU Box 297760 ● Fort Worth, TX 76129 ● Phone: (817) 257 - 7946 ● Fax: (817) 257 - 7467