Southern University-New Orleans-TS

EDUCATIONAL TALENT SEARCH PROGRAM (TRIO)
SOUTHERN UNIVERSITY AT NEW ORLEANS

6400 SUNO Knights Drive, New Orleans, Louisiana 70126 (504) 286-5209 Office
- To provide information and inspiration for future self-reliance.
  EDUCATIONAL TALENT SEARCH PROGRAM APPLICATION
  
  PROGRAM DESCRIPTION
  The Educational Talent Search Program (ETSP) is a federally funded project housed at Southern University at New Orleans (SUNO) that offers services to students at target high schools; high school drop outs and postsecondary stop-outs in Orleans Parish.
  
  The program is designed to provide information, assistance and motivation to all eligible participants from 11 to 27 years of age who desire to continue and complete their secondary education (high school or Graduate Equivalency Diploma) and move into postsecondary education arenas such as college, vocational/technical school, and apprenticeship programs prepared and confident. The major thrust of ETSP is to provide assistance with access to educational opportunities so that participants may move with self-reliance into a meaningful and productive future.
  
  Services provided by ETSP include tutoring, career guidance, academic counseling, counseling in personal development, assistance in gaining admission to postsecondary educational programs, help obtaining financial aid, and college tours and educational trips. These services are provided through a comprehensive counseling package which has been developed by the ETSP staff. This counseling package is presented in individual and group counseling sessions which are conducted throughout the year by the ETSP Advisors at the target schools. Each session is geared toward academic persistence by assisting participants in resuming, continuing and/or furthering their education.
  
  PARTICIPANT ELIGIBILITY
  Two-thirds of students participating in the Educational Talent Search Program must:
  - Must be 11-27 years of age (we can serve persons over 27);
  - Reside in the target parish;
  - Have family incomes which satisfy established low-income level
  - Be potential first-generation college students (neither parent holds a four-year degree)
  PROGRAM DELIVERY
  The ETSP staff will conduct a general session at the beginning of the year for the purpose of introducing the program and recruiting potential participants. Selected participants will be eligible to attend additional group and/or individual counseling sessions which will be held throughout the year.
- Name
  
  Student First NameM.I.Last Name
- Mailing Address
  
  Street Address
  
  Street Address Line 2
  
  CityState
  
  Zip Code
- City/State of Birth
- Social Security Number
  999-99-9999
- Home Telephone Number
  (999)999-9999
- Alternate No.
  (999)999-9999
- Date of Birth
  
  MonthDayYear
  mm-dd-yyyy
- Age
- Gender
- Are you a United States citizen?
- Email Address
  example@example.com
- School you are now attending
- Grade
- Are you enrolled in Dual Enrollment?
- If yes, where?
- Do you have any siblings in TRIO?
- If yes, whom?
- Check your nationality
  
  Other
- Who do you live with?
- Which do you plan to enroll in after completing high school?
- Listed below are some possible Educational Talent Search activities. Check the area(s) with which you would like information or need help with
  
  Other
- Student Signature
- Date
  
  MonthDayYear
  mm-dd-yyyy
- Name
  
  First NameLast Name
- Address
  
  Street Address
  
  Street Address Line 2
  
  CityState
  
  Zip Code
- Home Telephone Number
  (999)999-9999
- EMPLOYMENT INFORMATION
- Employed?
- If so, Employer Name
- Parent/Guardian Email address
  example@example.com
- Check the following services, which the participant receives
- Check Mother's Highest Education Level Completed
- Check Father's Highest Education Level Completed
- Check the total number of family members living at home (including participant)
- Please CHECK your Taxable Family Income from last year after deductions.
- Parent/Guardian Signature
- Date
  
  MonthDayYear
  mm-dd-yyyy
- Please carefully read the following release and agreement information, sign and return.
  
  In consideration of being accepted by Southern University at New Orleans (SUNO) for participation in the Educational Talent Search Program (hereinafter called ETSP), we (I), being 21 years of age or older, do hereby release, forever discharge and agree to hold harmless Southern University at New Orleans and ETSP and the staff thereof from any and all liability, claims or demands for personal injury, sickness or death, as well as property damage and expenses, of any nature whatsoever which may be incurred by the undersigned and the child-participant that occur while said child is participating in the above-described program.
  
  Furthermore, we (I) on behalf of our (my) child-participant, hereby assume all risks for personal injury, sickness, death, damage and expense as a result of participation in recreation and work activities involved therein.
  
  Further, authorization and permission is hereby given to said program to furnish any necessary transportation, food and lodging (when and if lodging is necessary) for this participant.
  
  The undersigned further hereby agree to hold harmless and indemnify said college, its administrators and employees from any liability sustained by said initiative as the result of the negligent, willful or intentional acts of said participant, including the expenses incurred attendant thereto.
  
  We (I) are the parent(s) or legal guardian(s) of this participant, hereby grant our (my) permission for him/her to participate fully in said program, and hereby give our (my) permission to take said participant to a doctor or hospital and hereby authorize medical treatment, including but in limitation of emergency surgery or medical surgery, of medical treatment, and assume the responsibility of all medical bills, if any.
- Please indicate by checking one space if your child is/is not currently taking prescription medication.
- If he/she is, this medication should be given to the necessary program official for dispensing. I further grant ETSP staff permission to administer over-the-counter medication to my child if necessary.
- My child has an allergic reaction to the following:
- Further, should it be necessary for the participant to return home due to medical reasons, disciplinary action or otherwise, we (I) hereby assume all transportation costs.
  
  We (I) understand that if the applicant is accepted by the Southern University at New Orleans ETSP, he or she will have to adhere to the rules and regulations concerning student responsibility and behavior in the academic and activities programs. We (I) understand that the director of the ETSP has the right to dismiss any student whose behavior is incompatible with the goals and standards of the program and/or that of the University.
  
  We (I) agree that the student, if accepted into the ETSP, may participate in answering questionnaires, test taking, and other appropriate assessments done as a part of the program’s evaluation. We also agree that photographs of the student taken during the program, papers written by the student during the program, and similar items may be used by SUNO ETSP in reports and public information materials. We (I) further agree to allow the SUNO ETSP to release, for educational purposes, photographs and video recordings, with or without audio, of program activities and projects involving the student.
  
  NOTE: SIGNATURES AFFIXED BELOW ATTESTS TO MY/OUR WILLINGNESS TO ABIDE TO THE FOREGOING RULES AND REGULATIONS.
  
  In compliance with Sec 402A (e) 1070a - 11of HEA, I hereby certify that the information I have furnished regarding the size of my family and taxable income is true to the best of my knowledge.
- Parent/Guardian Signature
- Date
  
  MonthDayYear
  mm-dd-yyyy