• TRIO Talent Search Participant Application

    6420 SE 15th Street, Midwest City, OK 73110 P: 405-736-0377 F: 405-733-7923
    • Student Information 
    • Date of Birth*
       - -
    • Gender
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    • Demographic Information 
    • Are you a U.S. Citizen?*
    • If no, are you a Legal Resident?
    • Ethnicity: Do you consider yourself Hispanic/Latino?*
    • Race (Check all that apply)*
    • Who do you live with*

    • What are you plans after high school?

    • What grades do you earn most of the time?
    • Are you enrolled in Upward Bound, Upward Bound Math/Science or GEAR Up?
    • Where are you interested in going to college? (check all that apply)

    • What workshops and activities would be most helpful to you? (check all that apply)
    • Student Commitment 

    • In order to participate in the RSC Talent Search program I agree to:

      • Attend and participate in all scheduled meetings, workshops, tutoring, or mentoring sessions
      • Have a desire to go to college
      • Strive to earn high grades in all classes
      • Refrain from having discipline/behavioral problems
      • Have respect for self and others
      • Successfully be promoted to the next grade each year in the program
      • Attend school regularly
      • Seek help with academic or personal problems if needed
      • Enroll in a post-secondary program after graduation
    • Clear
    • Date*
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    • Parent/Guardian Information 

    • TRIO Talent Search is funded through a grant from the Department of Education and must document student’s eligibility. All information requested is for these purposes and will be kept strictly confidential.

    • Mother's Highest Education Level Attained (biological or adopted)*
    • Father's Highest Education Level Attained(biological or adopted)*
    • Income Information 
    • Does your family meet or fall under the income requirements in the chart below for your family size?*

    • (Please note that income is for TAXABLE INCOME (IRS 1040 line 15) and not total income or Adjusted Gross Income. If you have any questions, please contact our office at (405)736-0377)

      Size of Family Unit Taxable Income Size of Family Unit Taxable Income
      1 $0 - $23,940 5 $49,501- $58,020
      2 $23,941 - $32,460 6 $58,021- $66,540
      3 $32,461- $40,980 7 $66,541- $75,060
      4 $40,981 - $49,500 8 $75,061- $83,580

      If more than 8 family members, add $8,520 for each additional family member.

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    • I give permission for images/video of my child, captured during RSC TRIO Talent Search activities through video, photo and digital camera, to be used solely for the purposes of RSC TRIO Talent Search promotional material and publications and sharing on social media, and waive any rights of compensation or ownership thereto. I understand that I may opt out of this agreement at any time.

    • By signing this form I agree that all information given is correct and accurate to the best of my knowledge. I further agree to allow my child to participate in the Rose State College Talent Search program and authorize the program to obtain the school records of my child for use in educational planning. This can include but is not limited to report cards, test scores or student information from student’s middle and high school records.

    • Clear
    • Date *
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    • Submit 
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