Owens State Community College-SSS

  • TRIO STUDENT SUPPORT SERVICES APPLICATION

    Per the Family Educational Rights and Privacy Act (FERPA), information in this application is confidential - we will protect your sensitive personal data. All sections of the application MUST be completed.

    Incomplete applications may be returned to you or rejected.

  • DOB*
     - -
    • Demographic Data 

    • (Note: the U.S. Department of Education will not recognize other designations outside of those listed below.)

    • Gender*
    • Marital Status*
    • Citizenship Status*

    • Race or Ethnicity (check all that apply)*
    • Do you speak English as a Second Language (ESOL)?*
    • Were you ever a member of any of the following Access Programs?*

    • Academic Information 
    • Did you graduate from high school?*
    • Did you receive a GED*
    • Type of student*
    • What is your current Owens State Community College academic status?*
    • Program Eligibility 

    • In accordance with federal regulations, a student must meet one of the following criteria to be eligible for program services:

    • In accordance with federal regulations, a student must meet one of the following criteria to be eligible for program services*
    • A first-generation college student (neither parent or guardian has a Bachelor’s degree)*

    • Note: First-generation is defined as neither parent having a bachelors (4-year) degree. ONLY custodial parents are counted for the purposes of first-generation status. If you do not know due to being an orphan or aging out of foster care, check this box

    • Have a documented disability**
    • *If yes, have you registered with the OCC Disability Resource Center?
    • Financial Eligibility 
    • 1. Are you married?*
    • 2. Are you at least 24 years old?*
    • 3. Do you have children or other dependents (other than a spouse) who receive more than half of their support from you?*
    • 4. At any time since reaching 13 years of age, were you an orphan, in foster care or a ward of the court?*
    • 5. Prior to reaching 18 years of age, were you an emancipated minor or did you have a court-appointed legal guardian?*
    • 6. Are you serving on active duty (for other than training purposes) in the U.S. Armed Forces?*
    • 7. Are you a U.S. veteran who was on active duty and was released under a condition other than dishonorable?*
    • 8. Are you homeless (lack a fixed, regular and adequate nighttime residence) or at risk of becoming homeless?*
    • 9. Are you designated as an Independent Student for financial aid here at Owens? (ONLY ANSWER  ‘YES’ IF YOU ANSWERED YES TO ANY OF QUESTIONS 1-8ABOVE)*
    • *If you and/or your family filed income taxes in 2022, what was your combined TAXABLEINCOME? Note: It is REQUIRED that you indicate TAXABLE income and not total income or adjusted gross income.  Taxable income is reported on: line 10 of form 1040. (Please note your application will be incomplete without the REQUIRED FIELDS marked with a*)**
    • Number of people living in your household including yourself*
    • Are you designated as an Independent Student for financial aid here at Owens?*
    • Have you completed an undergraduate (4-year) degree at any institution? (Note: Answering yes to this question makes the applicant ineligible to join SSS)*
    • Please check all that apply*
    • Has it been determined by a court in your state of legal residence that you are an emancipated minor or that you are in a legal guardianship?*

    • I hereby certify the information I have furnished regarding the size of my family and taxable income is true to the best of my knowledge. (Your application will not be complete without ALL REQUIRED signatures and dates.)

      Please sign, date this form. If you (the student) are less than 24 years old and answered NO to all the questions listed above, your parent or legal guardian must also sign and date below. (DUE TO COVID-19: Electronic signatures are being accepted)

    • Permission to take my picture for recognition and advertising purposes*

    • Please sign, date and return this form. If you are considered a dependent, as defined by Free Application for Federal Student Aid (FAFSA), you must have your parent/guardian sign and date this form.

      By typing your name in the signature box and submitting this completed application you are acknowledging that all the information being supplied is accurate and can be verified with official documentation. Typing in the signature box will serve as your official signature until a signature can be obtained in person.

    • Clear
    • Today's Date*
       - -
    • Clear
    • Today's Date
       - -
    • Permissions and Acknowledgements 

    • Note: Applying for this program is a commitment and we expect you to be an active participant while you are a student at Owens Community College

      If you are admitted to Owens Community College TRIO Student Support Services, we will require the following commitment from you:

      • I WILL meet with my SSS advisor at least twice a semester.
      • I WILL participate in tutoring sessions as needed.
      • I WILL participate in SSS financial aid and career development workshops and events.
      • I WILL set goals with my SSS advisor that lead to my planned graduation / transfer from Owens Community College.

      In applying for a federally funded program, you should know that anyone making a false statement or misrepresentation in establishing eligibility is subject to a fine or imprisonment or both under provisions of the U.S. criminal code. By my signature, I certify that the information provided in this application is true and correct to the best of my knowledge. Additionally, I give TRIO Student Support Services (SSS) my permission to access my educational records and other materials necessary for participation in the SSS Program. Furthermore, I understand that all my records are kept confidential and in accordance with Owens Community College and Federal Privacy Laws.

      Upon acceptance to the program, I agree to meet with my Academic Engagement specialist regularly, attend program activities and see a tutor regularly if enrolled in developmental courses, on Academic Warning, Dismissal, or repeating courses.

    • I give TRIO Student Support Services permission for release of my data (name, photos, data related to awards and achievements) for purpose of awards, recognition and advertising.*
    • I give TRIO Student Support Services permission to take my picture for recognition and advertising purposes:*
    • Clear
    • Date*
       - -
    • As a student, I want to (Check all that apply)*
    • Please check any of the following items which describe you*
    • What obstacle(s) would most likely prevent you from completing your academic goals? (Check all that apply)*

    • My most important areas which I will need assistance are (Check all that apply)

    • Financial*
    • Academic*
    • Personal Issues*
    • Transfer to a 4-year institution*
    • Career*
    • Rows

    • Note: Applying for this program is a commitment and we expect you to be an active participant while you are a student at Owens Community College.

      If you are admitted to Owens Community College TRIO Student Support Services, we will require the following commitment from you:

      • I WILL meet with my SSS advisor at least twice a semester.
      • I WILL participate in tutoring sessions as needed.
      • I WILL participate in SSS financial aid and career development workshops and events.
      • I WILL set goals with my SSS advisor that lead to my planned graduation / transfer from Owens Community College.

      Completed applications MUST include an active Owens Community College Student email account.

      Instructions after submission:

      1. A TRIO Student Support Services staff member will contact the applicant within 72 business hours to schedule a virtual intake interview.
        1. Virtual platform will be determined by TRIO SSS staff member.
    • How did you learn about Owens TRIO Student Support Services?

    •  

      TRIO Student Support Services

      Owens Community College

      30335 Oregon Rd.

      College Hall 158

      Perrysburg, OH 43551

      studentsupportservices@owens.edu

      567.661.7300

       

      TRIO SSS aligns with Owens Community College strategic plan Goal 1: Increasing Enrollment, Completion and Student Success, Goal 2: Improve and Enhance the Student Experience, and Goal 5: Improve College Culture and Quality of Life.

      Funded by the U.S. Department of Education

    • Submit 
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