Southern University-New Orleans-SSS-Application Form

SOUTHERN UNIVERSITY AT NEW ORLEANS
STUDENT SUPPORT SERVICES APPLICATION
Please answer all questions
SUNO Cohort Year
The academic year you entered SUNO
SSS Cohort Year
The academic year you entered SSS

Household Size (including self)

Size of Family Unit
Family's Taxable Income Level (Please retrieve taxable income information from your most recent federal tax returns) *Levels effective January 13, 2026, until further notice*
Has either of your parents received a high school diploma?
Mother
Father
Has either of your parents received a baccalaureate degree?
Mother
Father
Do you have a condition that may require reasonable accommodations to support your learning or participation in academic activities?
If yes, please explain
If yes, is this condition documented with the SUNO Office of Disability Services?

Are you a Dependent or Independent student?
Dependent Student Income Verification

I hereby certify that the financial information provided on the Student Support Services Application is accurate, to the best of my knowledge.
Parent or Legal Guardian's Signature

Clear
Witness' Signature

Clear
Date

MonthDayYear
Date
Print Student's Name

First NameLast Name
Independent Student Income Verification

I hereby certify that the financial information provided on the Student Support Services Application is accurate, to the best of my knowledge.
Student's Signature

Clear
Witness' Signature

Clear
Date

MonthDayYear
Date
Print Student's Name

First NameLast Name
Please upload most recent tax information (Tax returns) In lieu of a federal tax return, an SSI benefits letter or a self-declaration that you are not required to file taxes can be submitted. Please note: Applications without this submission are considered incomplete.

Browse Files

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Have you participated in any of the following programs?

Rows	Yes	No
Educational Talent Search
Upward Bound
Educational Opportunity Center
Honoré Center

Intended Major
Are you interested in pursuing a Master’s or doctoral degree?
Needs Assessment Form (Initial Selection - please only choose one)
Student Analysis: Check the items which describe your college needs

Other
I need tutoring assistance in
How did you hear of the Student Support Services (SSS) TRIO Program?
I certify that the information provided on this application is accurate to the best of my knowledge; that I am 18 years of age or older; and that I am a first-generation college student (neither of my parent(s)/guardian graduated from a four-year post-secondary institution), I am from a low-income household, and/or I have a documented disability. I also certify that the financial information provided on this application is accurate to the best of my knowledge and that Student Support Services has my permission to receive copies of my financial and academic records. (If under the age of 18, a parent or guardian must sign below.)
Student's Signature

Clear
Date

MonthDayYear
mm-dd-yyyy
Parent's or Guardian's Signature (if under the age of 18)

Clear
Witness

Clear
American College Test (ACT) scores and/or academic transcripts indicate that the applicant will need academic support to successfully pursue a Post-secondary educational program. This student, with the supportive services provided by the program, has the academic potential to earn a Bachelor’s degree.
Academic Coach's Signature

Clear
Date

MonthDayYear
Date
Director's Signature

Clear
Date

MonthDayYear
Date