Kankakee Community College-TS

Kankakee Community College

TRIO Talent Search - Application

Department of Student Affairs
Kankakee Community College
100 College Drive, Kankakee, IL 60901

The goal of the Talent Search program is to increase the number of youth from disadvantaged backgrounds who complete high school and enroll in the postsecondary education institute of their choice. We provide academic, career, and financial consulting to participants.

Family Information
Do either of your parents hold a four-year degree?*

YesNo
Who do you regularly reside with and receive support from?
Parent/Guardian Information
Name*

First NameMiddle NameLast Name
Relation
Cell #*
(999)999-9999
Home #*
(999)999-9999
Email*
example@example.com

If you have school-aged siblings, please provide their name and grade below

	First Name	Grade Level
1.
2.
3.

Acknowledgements
Kankakee Community College's TRIO Talent Search program is fully funded by the U.S. Department of Education.

By signing this application, you certify that the information submitted is correct. You understand this information is strictly confidential and will be maintained in the Talent Search office at Kankakee Community College.

I acknowledge the income information provided on this form is true and correct. I understand that I may be required to submit a signed copy of my U.S. tax return to prove income, as required by the Department of Education. If I fail to provide this documentation, I understand the applicant may not be accepted into the program.

I authorize my child's high school to release high school transcripts, test scores and grade reports.
Kankakee Community College’s TRIO Talent Search program is fully funded by the U.S. Department of Education
Authorization 1*

I certify that all information submitted is correct. I understand that this information is strictly confidential and will be maintained in the Talent Search office at Kankakee Community College.
Authorization 2*

I understand that if my child is accepted, participation is a privilege and that rules of the program must be adhered to, or my child risks consequences, which could include removal from the program.
Authorization 3*

I acknowledge the income information provided on this form is true and correct. I understand I may be required to submit a signed copy of my tax return to prove income or other form of supporting documentation, as required by the Department of Education. If I fail to provide this documentation, I understand my child may not be accepted into the program.
Authorization 4

I authorize Kankakee Community College and TRIO Talent Search to use my child’s image for promotional material such as advertising, publications, schedules, catalogs, web pages, social media, annual reports, recruiting presentations, view books, and other methods of communication.
Authorization 5*

I give consent for the release of my child’s school records, including transcripts, report cards, test scores, evaluations, and other information regarding school performance, in order to determine the impact of the TRIO Talent Search program services, as well as student eligibility requirements. This will be effective from this date and throughout my child’s participation in the program. All information will be kept confidential.
Parent/Guardian Signature*

Clear
Date*

MonthDayYear
mm-dd-yyyy
Student Signature

Clear
Date

MonthDayYear
mm-dd-yyyy

Submit
Please verify that you are human*

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