Welcome to TRIO/Student Support Services www.slcc.edu/trio/sss If you have questions or would like more information about TRIO/SSS contact us: Office: 801-957-4089 Salt Lake Community College Taylorsville Redwood Road Campus 4600 South Redwood Road Salt Lake City, Utah 84123
[email protected] Construction Trades Building Second Floor Room 226
Fax: 801-957-4683 Office Hours: Monday - Friday 8:00 a.m.-4:30 p.m.
Our purpose is to work in partnership with students to achieve academic success, improve student retention, and promote personal growth. Our services support the program goals of retention in college, graduation from college, and transfer to 4 year colleges and universities. Individualized Academic Planning – Managing all areas of your life can be overwhelming. We can help you build balanced plans that will allow you to meet your academic goals and personal life circumstances. Transfer Planning – It is never too early to start thinking about your transfer plans. We offer services to help you plan for transfer and build a network at the four year institution so when you enroll you have advocates Financial Planning – Our financial who are working with you to literacy services not only offer assistance continue your academic success. in applying for federal aid but finding scholarships and managing money for Tutoring – We offer free tutoring in school and life. Workshops and Activities – To help math and science. Our peer tutors will keep you motivated and meet people who help you understand class content and are working towards the same goals, we can help you build important study offer a variety of opportunities. skills. Students Who Meet the Following Criteria are Encouraged to Apply for Services US citizens or permanent residents who meet residency requirements for Federal student financial aid. Graduating from SLCC and Transferring to a Four Year School You need to be an admitted, degree seeking student who will graduate from SLCC and transfer to a 4 year institution to be eligible.
First generation College Students You are considered a first generation college student if neither of your parents (or the parent you live with) received a 4 year degree prior to your 18th birthday. It doesn't matter if anyone else in your family, like a brother or a sister, has a 4-year degree, just your parents.
Low Income Income guidelines are set by the Federal Government. If you qualify to receive federal financial aid, the chances are good that you meet the necessary income guidelines.
**Note: Students who meet the first generation OR the federal income guidelines AND all of the other criteria may qualify.
All students applying for TRIO/Student Support Services must submit income verification. Answer the questions below: Yes
No
Were you born before January 1, 1992?
Yes
No
As of today, are you married? (answer yes if you are separated, but not yet divorced.)
Yes
No
At the beginning of the 2015-2016 school year, will you be working on a master’s or doctorate program (such as an MA, MBA, MD, JD, PhD, EdD, or graduate certificate, etc.)?
Yes
No
Are you currently serving on active duty in the U.S. Armed Forces for purposes other than training?
Yes
No
Are you a veteran of the U.S. Armed Forces?
Yes
No
Do you have children who will receive more than half of their support from you between July 1, 2015 and June 30, 2016?
Yes
No
Do you have dependents (other than your children or spouse) who live with you and who receive more than half of their support from you, now and through June 30, 2016?
Yes
No
At any time since you turned age 13, were both your parents deceased, were you in foster care or were you a dependent or ward of the court?
Yes
No
As determined by a court in your state of legal residence, are you or were you an emancipated minor?
Yes
No
As determined by a court in your state of legal residence, are you or were you in legal guardianship?
Yes
No
At any time on or after July 1, 2014, did your high school or school district homeless liaison determine that you were an unaccompanied youth who was homeless?
Yes
No
At any time on or after July 1, 2014, did the director of an emergency shelter or transitional housing program funded by the U.S. Department of Housing and Urban Development determine that you were an unaccompanied youth who was homeless?
Yes
No
At any time on or after July 1, 2014, did the director of a runaway or homeless youth basic center or transitional living program determine that you were an unaccompanied youth who was homeless or were self-supporting and at risk of being homeless?
After answering the questions, check the box that applies: If you answer NO to every question, you are a DEPENDENT student. Bring in a signed copy of your parent’s U.S. (federal) tax return for last year. If you answer YES to ANY question, you are an INDEPENDENT student. Bring in a signed copy of your U.S. (federal) tax return for last year. If you or your parents did not file taxes, discuss alternative forms of income verification with a TRiO/SSS Advisor.
Revised March 2016 Questions from the 2015-2016 FAFSA
TRIO/ Student Support Services Application (Please fill out form completely)
If you are not currently enrolled at SLCC when do you plan on attending? _____________________________________
Name___________________________________________________ SSN_____________________ last first middle S#______________________ Address _________________________________________________ Home phone _____________ City/State/Zip____________________________________________ Cell Phone _______________ Your e-mail address ___________________________________ Preferred: Home or Cell Permanent Contact _______________________________________ Relationship______________ last first middle Address ____________________________________________ Phone___________________ City/State/Zip _______________________________________ Citizenship:
US Citizen
Permanent Resident A#_____________ Other_____________
(please bring your permanent resident card so we can make a copy)
First Generation: What is the highest level of education completed by your Father__________________________________________________________ Mother _________________________________________________________ Low Income:
Are you a Dependent or an Independent student? What income verification documentation have you attached? _______________
Academic Plan:
What year did or will you first start college? __________ Where? ___________ What degree are you working toward? _________________________________ What is your course of study (major)?__________________________________ Are you planning to graduate from SLCC? Yes No Are you planning to transfer to a 4-year school? Yes No If yes, where do you plan to transfer?__________________________________
Who referred you to the TRIO Program?__________________________________________________ Have you participated in a TRIO program (Talent Search, Upward Bound, Student Support Services, etc.)? If yes, where_________________________________________________________________
The following information is for federal reporting purposes only and must be completed. It does not determine your eligibility for the program. If you have questions, please ask us. Gender: Male Female
Ethnicity: Are you Hispanic/Latino? Race: (Select 1 or more) White Asian African American/Black
Date of Birth _________________
Married
Single
Yes
No
American Indian/Alaska Native Native Hawaiian/ Pacific Islander
#Children____ Age(s)_____
Informed Consent I authorize TRIO/Student Support Services (SSS) to gather information concerning my academic progress and financial aid status. I understand that this information is used to assist in the determination of my eligibility for SSS and it will be strictly confidential. I grant permission for SSS to gather information for follow-up whenever appropriate, including transfer and progress at 4-year institutions. I am aware that SSS reports to the U.S. Department of Education in accordance with the grant funding regulations. I certify that the information provided on this application is true and complete to the best of my knowledge. I agree to provide documentation upon request to verify the information reported. I am aware that the personal information provided to SSS is protected under the Family Education Rights and Privacy Act of 1974. Signature
Date Photographic Release Form
I hereby give Student Support Services and Salt Lake Community College the unqualified right and permission to reproduce, copyright, publish, circulate or otherwise use my name and/or photographic likeness of me still, single, multiple, or moving in which I may be included in whole or in part, or composite. I understand that my photo may be used in publications under the direction of Student Support Services or Salt Lake Community College. I waive any right to inspect and approve the finished product or copy that may be used or the use to which it may be applied. This authorization and release covers the use of said materials in any published or broadcast form. Signature
Date
Office For For Office Use Use OnlyOnly Status Status [document [document in in dictation] dictation] Accepted First Low Physically/Learning Accepted First Generation Generation Low Income Income Physically/Learning Disability Disability Not Accepted: Reason ___________________________________________________ Not Accepted: Reason___________________________________________________ Academic Academic Need Need [document [document in in dictation] dictation] 01 Low high school 01 Low high school grades grades 02 02 Low Low admission admission test test scores scores 05 Predictive indicator 05 Predictive indicator 06 06 Academic Academic proficient proficient tests tests 07 Low college grades 07 Low college grades 08 08 High High School School equivalency equivalency [GED] [GED] 09 Failing grades 09 Failing grades 10 10 Out Out of of academic academic pipeline pipeline 5+ 5+ yrs yrs
11 11 12 12 13 13 14 14
Other Other Limited Limited English English proficiency proficiency Lack of educational Lack of educational and/or and/or career career goals goals Lack Lack of of academic academic preparedness preparedness for for college college level course work level course work 15 15 Need Need for for academic academic support support to to raise raise grade(s) in required course(s)/academic grade(s) in required course(s)/academic major major
Advisor Advisor signature_________________________________ signature_________________________________ Project Project Entry Entry Date________________ Date
Rev March 2016
This is not a test! These questions and your answers will help us understand where you are academically and how our services can help you successfully reach your goals. •
Did you receive a
high school diploma
•
Have you ever attended college?
•
Are you transferring any credits to SLCC from another college or university?
•
Describe your high school and/or previous college experience_____________________________
Yes
GED
Year______
Where?_______________
No
Year______
Where?_______________ Yes
No
_______________________________________________________________________________ •
How have your educational experiences and life experiences prepared you for college? ________ _______________________________________________________________________________
•
Do you feel unprepared for college? If so, how?________________________________________ _______________________________________________________________________________
•
Describe your career goals _________________________________________________________ _______________________________________________________________________________
•
Describe your academic goals_______________________________________________________ _______________________________________________________________________________
•
What degree are you seeking?
•
What is your major _______________________________________________________________
•
Other ______________________________ Yes
No
•
Are you familiar with your academic program requirements?
Yes
No
Have you taken the Accuplacer (for math and English placement)?
Yes
No
What classes did you place in?
Math_________ English__________ Reading _________
What is your projected graduation and/or transfer date? __________________________________ Have you planned a timeline to graduation and/or transfer?
Have you applied for Federal Financial Aid? •
•
AAS
Are you familiar with your academic program pre-requisites?
• •
AA
•
• •
AS
Have you been awarded?
Yes
No
Yes
No
Yes
No
Please list any other agencies you are receiving assistance from: ___________________________ ________________________________________________________________________________
•
Do you know the difference between dropping or withdrawing from a class?
Yes
No
•
Do you have any questions or comments?______________________________________________ ________________________________________________________________________________ ________________________________________________________________________________
