Trident Technical College-TS-Application Form

Talent Search Enrollment Application

Trident Technical College / PO Box 118067 SS-B/ Charleston, SC 29423-8067/ 1.843.899.8085

All sections must be completed and submitted in order to be considered for entry into the program.

Si desea ver el formulario en español, cambie el idioma en la esquina superior derecha.

Full Name*

First NameMiddle InitialLast Name

Date of Birth*

mm-dd-yyyy

Age

SS#*

999-99-9999

Current Grade*

School*

School Name*

Student ID #

Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Student Phone #*

(999)999-9999

Student School E-mail*

example@example.com

Student Personal E-mail (Gmail, Yahoo, iCloud, etc.)*

example@example.com

Confirm email

example@example.com

Gender*

MaleFemale

Citizen

Ethnic Origin (Please check all that apply)*

Name of Mother/Legal Guardian*

First NameLast Name

Cell#*

(999)999-9999

Mother/Guardian Email *

example@example.com

Name of Father/Legal Guardian*

First NameLast Name

Cell#*

(999)999-9999

Father/Guardian Email*

example@example.com

Does either of your parent have a 4-year degree?*

YesNo

Does the student receive free or reduced lunch?*

YesNo

Including yourself, how many people live in your home?*

Please check the annual taxable income range appropriate for your family.*

Please check all services that you need assistance with*

1. What subject(s) could you use help or tutoring with?*

2. Which classes are you taking?*

3. I would like to*

4. List three careers you are interested in and would like information about.*

5. List three colleges you are interested in and would like information about.*

Please note that students may not enroll and participate in both the Upward Bound and Talent Search programs at the same time.

Are you enrolled in the Upward Bound program?

YesNo

Student Name (printed)*

First NameLast Name

Information Release

I/We authorize Educational Talent Search (ETS) to obtain documents relative to and consistent with my child’s education. Such documents may include: a copy of his/her school transcript, test scores, ACT/SAT or GED scores, special education documentation, school lunch program eligibility, financial aid forms, letter of admissions, and necessary documentation for follow-up on my child’s admittance to an educational institution. I certify that the information on this form and any attachments are true, complete, and accurate to the best of my knowledge. I understand that this information will remain strictly confidential.

Parent/Guardian Signature*

Date*

mm-dd-yyyy

Student Signature*

Date*

mm-dd-yyyy

Media Release (optional)

I hereby give permission to Trident Technical College Educational Talent Search program to use my child’s name, image, work, and/or statements for promotional, publicity, and instructional purposes.

Parent/Guardian Signature*

Date*

mm-dd-yyyy

Applicant Information

Household Income

Academic & Career Assessment

Parent/Guardian- Student Commitment