• Student Support Services

    Application Form 2020-2021
    • Student Information  
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    • Per. Federal Regulations: “Hispanic/Latino refers to a person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race. As such, every Hispanic/Latino person has an associated race(s).”

    • *While we respect the Gender Identity of all students, we are required to report Legal Sex as part of federal requirements.

    • Education Information  
    • Parent Information  

    • Financial Statement of need

      (The taxable income can be found on the U.S. Individual Income Tax Return - IRS form 1040 see line 11b). NOTE: Family is defined as anyone who claims you as a dependent on their taxes regardless of your age - IF YOU ARE AN INDEPENDENT STUDENT – You must to enter your taxable income information

    • Verification and Release of Information  

    • All information I have submitted on this form is true and complete. I understand this information is confidential and will be used for statistical and verification purposes. Further, in order to verify my eligibility and in the event that I am accepted to the Success at Southern/ TRIO-Student Support Services (SSS) at Southern Oregon University, I release the following information to the Success at Southern/TRIO-SSS Program:

      • Southern Oregon University Academic and Admission/Registration/Financial Aid Documentation
      • Southern Oregon University Interdepartmental Consultation
      • Midterm and Final Grades Information
      • Disability Documentation
      • Income Information (Federal 1040 or other appropriate income documentation if required)

      Additionally, (1) I agree to complete an exit interview in the event of withdrawal, transferring, or graduation from SOU.
      (2) I understand that Success at Southern/TRIO-SSS administrators will contact my instructors on an as needed basis.

    • Clear
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    • PLEASE CHECK THAT YOU HAVE COMPLETED AND HAVE ANSWERED ALL QUESTIONS. FAILURE TO COMPLETE IT WILL RESULT IN YOUR APPLICATION BEING REJECTED.


      IMPORTANT: We like to recognize student achievements. Do you grant permission to include your name or picture for program related publicity, exhibits or displays? Please indicate preference by initialing:

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