Bluegrass Community & Technical-Lexington-SSS-Application Form

  • TRIO STUDENT SUPPORT SERVICES

    Lexington Campuses - Program Application

  • Student Support Services is a federal program funded through the U. S. Department of Education and sponsored by BCTC, an equal opportunity institution. Acceptance into the program is contingent upon meeting eligibility criteria and space availability.  Information gathered on this application will be used to determine eligibility and will be held in strict confidence.

    • PERSONAL INFORMATION 

    • PERSONAL INFORMATION

    • Date of Birth*
       - -
    • Gender*
    • Race (check all that apply)*
    • Ethnicity - Hispanic or Latino*
    • EDUCATIONAL INFORMATION 

    • EDUCATIONAL INFORMATION

    • Have you previously participated in other TRIO programs such as Talent Search or Upward Bound?

    • OR

    • Do you plan on earning an Associate’s Degree or credential from BCTC?
    • Do you plan on transferring to a 4-year institution?
    • NEEDS ASSESSMENT 

    • NEEDS ASSESSMENT

      I could use help in the following areas:

    • ACADEMIC
    • ACADEMIC RELATED
    • CAREER
    • PERSONAL
    • ELIGIBILITY INFORMATION 

    • ELIGIBILITY INFORMATION

    • U.S. Citizen*
    • If no, are you a permanent resident alien of the U.S.?*
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    • Are you an individual with a documented disability?
    • If yes, have you registered with the BCTC Office of Disability Support Services?
    • Has either of your parents or legal guardians you grew up with graduated with a 4-year bachelor’s degree?*
    • DEPENDENCY STATUS 

    • DEPENDENCY STATUS

    • Marital Status*
    • Do you have any children or dependents (other than a spouse) who receive more than half of their support from you?*
    • At any time since reaching 13 years of age, were you an orphan, in foster care, or ward of the court?*
    • Prior to reaching 18 years of age, were you an emancipated minor or did you have a court appointed legal guardian?*
    • Are you serving on active duty (for other than training purposes) in the Armed Forces?*
    • Are you a US Armed Forces veteran who was on active duty and was released under a condition other than dishonorable?*
    • Are you homeless or are you at risk of becoming homeless?*
    • FINANCIAL INFORMATION 

    • FINANCIAL INFORMATION

    • Have you applied for financial aid?
    • Did you file a Federal Income Tax Return for the last calendar year?

    • *NOTE: Please only include your information if marital status is married, separated, or widowed, if you answered “Yes” to any of the above Dependency questions, or if you are 24 years old or older. Otherwise, please include the income of your parent(s)/guardian(s). Taxable income can be found on the Federal Income Tax Return. On IRS form 1040, see line 15.

    • STUDENT RELEASE 

    • STUDENT RELEASE

      By signing below, I hereby verify that all the information provided on this application is accurate to the best of my knowledge.  I hereby give permission for the BCTC Student Support Services program to review any available academic and financial aid records deemed necessary.  I understand that this information is confidential and withholding information on this application or giving false information will make my application ineligible for admission to the BCTC SSS program.

    • Clear
    • Date Signed*
       - -
    • Submit 
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