Lock Haven University Of Pennsylvania-SSS

You selected that your campus designation is not Lock Haven. Based upon this answer, you do not qualify for Lock Haven’s TRIO SSS program. If you believe this an error, please email our office triosss@lockhaven.edu so we can assist you further.
TRIO Student Support Services Application

The following information is required to determine eligibility for the TRIO SSS program. Students who wish to participate in TRIO SSS must meet certain federal requirements. The information you provide will be kept confidential. The form must be completely filled out to be considered. If you have questions about the application, please email triosss@lockhaven.edu .

Please note: Per federal stipulations, the TRIO SSS grant serves only students designated as enrolled at LHU Main Campus.
- Application Date*
  
  MonthDayYear
  mm-dd-yyyy
- Legal Name*
  
  First Middle InitialLast
- Preferred Name
- Address*
  
  Street
  
  Street Address Line 2
  
  CityState
  
  Zip Code
- Cell Number*
  (999)999-9999
- Home Number
  (999)999-9999
- LHU Email Address*
  example@lockhaven.edu
- LHU ID*
- Date of Birth*
  
  MonthDayYear
  mm-dd-yyyy
- Gender*
  
  MaleFemaleOther
- Preferred Pronouns
- Citizenship*
  
  U.S. CitizenPermanent ResidentOther
- Are you Hispanic or Latino/a? (Note: 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).)*
  
  YesNo
- Race (Select all that apply)*
  
  American Native or Alaskan NativeCaucasian/WhiteAsianNative Hawaiian/Pacific IslanderBlack or African American
- Former TRIO Participant?*
  
  YesNo
- Indicate the program(s) below:*
  
  Upward BoundUpward Bound Math/ScienceVeteran’s Upward BoundTalent SearchMcNairStudent Support Services (SSS)Educational Opportunity Centers (EOC)
- How did you hear about the TRIO SSS Program? Check all that apply.
  
  Academic AdvisorAccepted Student EventCampus DepartmentAnother TRIO ProgramEmailFriendLHU WebsiteOpen HouseSocial MediaStudent OrientationText MessagePostcardOther
- Due to federal grant regulations, the Lock Haven TRIO SSS program can only accept students whose campus location is Lock Haven. Please indicate which is applicable to you. If you are unsure of your campus designation, please check your Banner student profile.
  
  Lock Haven IS my campus designationLock Haven IS NOT my campus designation
- ACADEMIC BACKGROUND
- Please select the statement that best applies to you:*
  
  First time Lock Haven University Freshman during the 2025-2026 academic yearFirst time Lock Haven University Student during the 2026-2027 academic yearCurrent Lock Haven University Student (second year or above)Incoming Transfer Student
- High School Name*
- Intended Major*
- Status*
  
  Full-TimePart-Time
- Are you interested in pursuing a degree beyond the Bachelor’s (4-year) level?*
  
  YesNo
- Major*
- Status*
  
  FreshmanSophomoreJunior
- Current Cumulative GPA*
- Are you interested in pursuing a degree beyond the Bachelor’s (4-year) level?*
  
  YesNo
- College/University transferring from:*
- Reason for transfer:*
- Major*
- Status*
  
  Full-TimePart-Time
- Are you interested in pursuing a degree beyond the Bachelor’s (4-year) level?*
  
  YesNo
- I certify that the information provided is accurate and complete to the best of my knowledge. I hereby grant permission to the office of Student Support Services (SSS) to obtain any information necessary for eligibility verification for participation in the LHU TRIO SSS program. By volunteering to become a program participant, I am authorizing SSS employees to have discussions with the University faculty and staff with whom I will interact regarding my academic, financial, and personal needs with the intent to help me succeed as a student to obtain my degree. I am also making a commitment to participate in SSS programming throughout the year.
- To sign please use your mouse or touch screen.
- Student Signature *
  
  Clear
- Student Name*
  
  First NameLast Name
- Date Signed*
  
  MonthDayYear
  mm-dd-yyyy
- TRIO Student Support Services Eligibility Verification Section
  
  Student Support Services (SSS) is a federally funded TRIO Program under the United States Department of Education. In order to qualify to participate, students must meet certain criteria. The questions asked on this page will aid in determining your eligibility for the LHU SSS Program.
  Please complete all areas of the form completely in order to prevent any delays in your application.
  
  In the event of a Department of Education program audit, participants and their
  parents/guardians may be asked to provide copies of tax returns to document the financial information below.
  
  Part I: First-Generation Verification
- Select the option that best applies to you:*
  
  I AM a first-generation college student because neither father/mother/guardian (biological or adoptive) with whom I reside did not receive a four-year (Bachelor’s) degree.I am NOT a first-generation college student because my father/mother/guardian (biological or adoptive) with whom I reside, did graduate with a four-year (Bachelor’s) degree from a college or university.
- Part II: Financial Eligibility Verification
  
  You are a dependent if you are claimed on your parents’/guardians’ tax return. Please complete the following information for you and your parent(s)/guardian(s).
- Number of people in your household (including yourself)*
- Parent(s)/guardian(s) 2023 TOTAL TAXABLE income (not adjusted gross income). This information can be found on line 15 of the federal 1040 tax form. (If parents/guardians filed “married filing separately” be sure to add taxable income from both tax forms). ($)*
- Your 2023 TOTAL TAXABLE income (if applicable). This information can be found on line 15 of the federal 1040 tax form. ($)*
- If applicable:
  
  Check here if you are an independent student and DID NOT OR WILL NOT FILE a federal tax return for 2023.Check here if your parent(s)/guardian(s) DID NOT OR WILL NOT FILE a federal tax return for 2023.
- Part III: Disabilities Verification
- Have you ever had an IEP (Individualized Education Plan) and/or a 504 Plan?*
  
  YesNo
- Do you plan to register with the Office of Disability Services?(Disabilities can be learning, physical, or psychological.)*
  
  YesNo
- (If you have not registered, please contact The Office of Disability Services at Disability_Services@lockhaven.edu to complete the registration process. Lock Haven University is committed to providing equal access and full participation in programs to students with disabilities. Services, reasonable accommodations, support and advocacy will be designed to provide an accessible learning environment.)
- Certification Statement
  By signing below, I/we verify that the information on this form is accurate and complete to the best of my/our knowledge. This information will be kept confidential in a secure location and will be used only by TRIO SSS staff to verify eligibility for the services of the program.
- To sign please use your mouse or touch screen.
- Parent/Legal Guardian Signature*
  
  Clear
- Parent/Legal Guardian Name*
  
  First NameLast Name
- Date Signed*
  
  MonthDayYear
  mm-dd-yyyy
- Student Signature*
  
  Clear
- Student Name*
  
  First NameLast Name
- Date Signed*
  
  MonthDayYear
  mm-dd-yyyy
- TRIO Student Support Services (SSS) Self-Inventory
  
  Please check all the items that apply to your individual situation. By providing this information, you will ensure that the SSS Program provides the best resources for your personal, academic, financial, and professional development.
- Please indicate, below, challenges you may face in attaining your college goals and earning your degree. Please check all that apply.
- Academic Challenges*
  
  Undecided about majorUndecided about course selectionUnderprepared in study strategiesUnderprepared in mathUnderprepared in scienceUnderprepared in readingUnderprepared in writingTest anxietyOther
- Financial Challenges*
  
  Lack of information about financial aidLack of information about scholarshipsLack of information about loansConcern about affording my educationConcern about working while attending schoolOther
- Please indicate, below, resources you may need to attain your college goals and earn your degree. Please check all that apply.
- Academic Resources*
  
  Academic advising/help with course selectionAcademic tutoringTime management strategiesNote-taking strategies for college-level classesAssistance with writing assignmentsCoaching in study strategies/test-taking skillsAcademic accommodationsOther
- Financial Resources*
  
  Financial aid advisingFinancial planning and money skillsBudgetingScholarship information and application assistanceEmployment opportunitiesOther
- Please indicate, below, challenges, you may face in attaining your college goals and earning your degree. Please check all that apply.
- Personal Challenges*
  
  Adjustment to collegeMotivation/goal-settingDecision-makingRelationshipsLack of support from family or friendsStress/anxietyConcerns as a commuting studentDisconnected youth (in legal guardianship, emancipated minor, homeless, involved in foster care)Self-careOther
- Professional Development Challenges*
  
  Undecided about career/professional goalsLack of information about graduate/professional schoolLack of information about internshipsLack of information about resumes/cover lettersLack of professional mentorConcerns about job searching/interview preparationOther
- Please indicate, below, resources you may need to attain your college goals and earn your degree. Please check all that apply.
- Personal Resources*
  
  Social activities and opportunitiesAdvising in goal settingStress managementCounselingWellness/health resourcesAssistance with personal/legal paperworkVolunteering/community service opportunitiesCultural enrichment activitiesLeadership developmentOther
- Professional Development Resources*
  
  Career advisingCareer choice toolsGraduate/professional school advisingAssistance with applying for jobs/internshipsOpportunities to shadow a professionalOpportunities to work with a professional mentorOther