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Fill out the form below to apply for TRIO assistance.

(e.g. xxx-xxx-xxxx)
Select of one of the following
I certify that the information on this application is accurate and complete to the best of my knowledge. I understand that falsification of this information constitutes fraud. I authorize TRiO Student Support Services to obtain any information from my educational and financial records that may be pertinent to my participation in the program (i.e. transcripts, ACT/SAT scores, grades, etc.). I understand The Department of Education requires social security number reporting as a condition for TRiO participation, and that my SSN will remain private and confidential. I authorize TRiO Student Support Services to include my photograph in my file and use images of me for program and publicity purposes. *
Please type your full name as your digital signature