Indian Hills Community College-TS-Application Form

PARENT APPLICATION

Educational Talent Search at Indian Hills Community College is a free, educational program designed to assist 6th through 12th grade participants in their preparation for enrollment into any college of their choice. All information on this application is confidential; your information will never be shared with anyone outside of the Educational Talent Search office.

Student Information

Student Name

First NameMiddle InitialLast Name

Address

Street Address

Street Address Line 2

CityState

Zip Code

Is English the student’s second language?

Student is:

Student’s Social Security Number/A-Number/ITIN. Enter 000-00-0000 if unavailable.

999-99-9999

USCIS#

Student's Ethnic Origin (select 1 or more races)

Student is:

TOTAL Number of people in household

Who does the student reside with? (Select all that apply)

Parent Cell #

(999)999-9999

Student Cell #

(999)999-9999

Household Composition

Names of parent/guardian student is living with

Parent/Guardian 1

First NameLast Name

Address

Street Address

Street Address Line 2

CityState

Zip Code

Did Parent/Guardian 1 graduate from a 4-year college in the U.S.?

What college?

Cell Phone

(999)999-9999

Email

example@example.com

Parent/Guardian 2

First NameLast Name

Address

Street Address

Street Address Line 2

CityState

Zip Code

Did Parent/Guardian 2 graduate from a 4-year college in the U.S.?

What college?

Cell Phone

(999)999-9999

Email

example@example.com

You must include your adjusted gross income for us to process your application

Type in your household’s adjusted gross income

OR

Please attach a copy of your most recent tax forms if possible

Browse Files

Sign up additional 6th - 12th grade children for Educational Talent Search below:

Rows	Student Name	Date of Birth	Social Security #	Grade	School
1.
2.
3.
4.
5.

Please list all persons (siblings or other relatives) living in the home and their grades in school:

Your signature below will certify as to the truth of the statements made on this form and will also serve as an authorization for the Educational Talent Search program to request and receive information from your school (including, but not limited to, period report cards, free or reduced lunch status, social security number, standardized test results, use of photographs (including, but not limited to, the ETS webpage and ETS Facebook page), and any information or transcriptions from your school or future college that might be pertinent to the program). It will also imply your permission for the student to take part in all activities related to Educational Talent Search.

Parent's Signature

Date Signed

mm-dd-yyyy

TRIO Educational Talent Search is 100% federally funded by the U.S. Department of Education in the amount of $288,470. per year.

EDUCATIONAL TALENT SEARCH