Mount Wachusett Community College-NCM-TS-Application Form

North Central MA Talent Search
Student Application
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The primary goal of the North Central MA Talent Search (NCMTS) grant is to assist participants to successfully complete middle and high school and enroll
in postsecondary education. NCMTS offers services to 500 individuals in grades six through twelve, of whom at least two-thirds must be income-eligible and potential first-generation college students.

Both individual advising and group activities provide participants of Talent Search with academic, career, and personal development. Workshop topics include enhancing study strategy techniques, selecting college-preparatory
high school courses, completing career assessments, building self-esteem, preparing for the PSAT/SAT, transitioning to college, college admissions procedures, and completing financial aid forms. Early College Planning workshops are held for middle school families. Leadership conferences enhance student’s preparation for postsecondary education. Students also participate in various community service activities.

Specifically designed for disadvantaged students, NCMTS is one of the nationwide TRIO programs created through federal legislation over 50 years ago. TRIO participants represent a variety of ethnic and cultural backgrounds.
Mount Wachusett Community College has administered the NCMTS program since Fall of 1992. NCMTS is 100% funded by the U.S. Department of Education. The total funding for this grant is $240,000 annually.

The staff of NCMTS provides services to eligible participants. If you have a disability and may require accommodations in order to participate fully in program activities, please contact Ralph Hogan, NCMTS Director to discuss your specific needs at 978-630-9448.

Each of our participating school districts has an NCMTS advisor assigned to their students. The information below will help you to reach out to your advisor, should you have any questions about our program.
To participate in the NCMTS program at your school, please fill out the attached application and return it to your NCMTS advisor. Please note that your application will not be reviewed until the entire application is complete.

Emergency Contact Information
This should be a non Parent emergency Contact
Name*

First NameLast Name
Relationship*
Home Phone*
(999)999-9999
Cell Phone*
(999)999-9999

Custodial Parents/Guardian Information
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home or Cell Phone*
(999)999-9999
Email*
example@example.com
Court Documents

Browse Files

Cancelof

Parent Consent and Liability Release
Parent/Guardian Name*

First NameLast Name
Student Name*

First NameLast Name
I, {parentguardianName96} give my son/daughter/ward, {studentName97} permission to participate in the Mount Wachusett Community College (MWCC) North Central MA Talent Search (NCMTS) Program. I also absolve MWCC, the NCMTS Program, their personnel and the Athol, Clinton, Orange, Sizer, and Winchendon School Systems of any liabilities and claims arising from my child’s participation, and attendance in MWCC NCMTS program, including travel to and from such events and activities.

I consent to and authorize emergency and non-emergency medical care to be provided to my child in the unlikely event of a health problem, emergency or injury occurring during my child’s attendance in the NCMTS program. I give my consent and authorization to appropriate NCMTS members to use their judgment in seeking medical care for my son or daughter. I understand that an attempt will be made to contact me in the event that emergency medical care is needed.

I give permission for the NCMTS program to obtain the academic records/information for the above named student throughout his/her high school career and for six years following his/her graduation to allow for annual tracking of NCMTS participant’s education as is required by Federal Department of Education regulations to evaluate the NCMTS Program. I understand that this information will be held in compliance with FERPA and other applicable state laws and will only be accessible to appropriate program staff and Department of Education personnel.

I consent to have the NCMTS program contact me through Remind.com using the e-mail and cell phone number provided above. I understand I can opt out of this when I receive a message from Remind.com.

I further give permission for the NCMTS program to use pictures, videotapes or audio recordings of the above named student for all program related purposes, including for publication in newspapers and other media. If I do not wish for the NCMTS program to use pictures, videotapes or audio recordings of the above named student I will submit written notification to the program and attach to this application. This consent will remain in effect until its written revocation is received by the NCMTS program at MWCC, 444 Green Street, Gardner, MA 01440.
Parent/Guardian Signature*

Clear
Date*

MonthDayYear
mm-dd-yyyy

Student Code of Responsibility and Expectations
1. Students are expected to attend school every day.
2. Students are expected to meet with their TRIO advisor.
3. Students are expected to attend any and all workshops, and to fully participate in the program.
4. Students are expected to demonstrate model behavior in and out of school, including while on any and all field trips.
5. Students are expected to take advantage of every opportunity offered in order to make their time with us as beneficial as possible.
6. Students are expected to share academic information with NCMTS staff in order to assist in planning and tracking. Student must also give staff permission to access information relating to their academic progress.
7. Students are expected to have fun and do their best!
I have read the above rules and promise to uphold them and to be a good representative of my school and the NCMTS program. I understand that any serious breach of behavior may result in dismissal from the program.
Student Signature*

Clear
Date*

MonthDayYear
mm-dd-yyyy

Student Needs Assessment
Name*

First NameLast Name
School*
Current Grade*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone*
(999)999-9999
Email Address*
example@example.com
The following survey contains a number of statements regarding various aspects of student needs. We ask that each student give their honest opinion about how the NCMTS program can help to meet their particular needs. All answers will be kept confidential. Please circle that which best describes you.

Student Needs*

	Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree
1. I need to get better grades in school.
2. I need to learn how to take better notes.
3. I need to learn test taking strategies and techniques.
4. I need to develop strong study skills and habits.
5. I need to learn how to read a text book more effectively.
6. I need to develop or improve my time management skills and habits.
7. I need to know how to prepare for a career that interests me.
8. I need to learn how to get involved in clubs and organizations.
9. I need help visiting college campuses.
10. I need to experience more cultural activities.
11. I need to learn which high school courses are necessary for college.
12. I need information on college prep courses and dual enrollment.
13. I need to learn about college programs and degrees.
14. I need to learn more about ACT / SAT testing.
15. I need help applying to college & understanding the process.
16. I need to learn more about filling out financial aid applications.
17. I need to learn about how to search for scholarships.

Student Signature*

Clear
Date*

MonthDayYear
mm-dd-yyyy