Massachusetts College Of Liberal Arts-SSS-Application Form

  • MCLA Student Support Services Application

    • Personal Data 
    • Date of Birth*
       - -
    • Sex assigned at birth*
    • Gender Identity
    • Pronouns

    • Are you of Hispanic / Latino(a) descent?*
    • Race Check all that apply*

    • Are you enrolled in at least 6 credits?*
    • Eligibility 
    • Have you completed a bachelor's degree?*
    • Are you a U.S. citizen or permanent resident?*
    • At the time of your 18th birthday, did your custodial caretaker possess a 4-year degree from a College or University?*
    • Do you receive Financial Aid?*
    • Do you have a documented disability on file in MCLA’s Disability Resource Center?*
    • Academic Need 
    • Check all that apply*
    • Release 

    • I authorize the release of information from my financial and/or academic record as requested by the TRIO Program or as needed by Federal, State or Financial Aid organizations for any legitimate purpose. I also authorize the TRIO staff to verify disability documentation with the Coordinator of the Disability Resource Center, if applicable. In addition, I give TRIO permission to talk to others who are directly involved in my education for the sole purpose of assisting me in the pursuit of my educational objectives. Faculty, Tutoring, all TRIO staff, Academic Advising, Financial Aid, Counseling Services, Disability Services, and Student Billing are examples of some of the professionals that we may collaborate with in helping you achieve your goals.

      I understand that any related information will remain confidential and will be used only to:

      1. establish eligibility for special services;

      2. assess my academic progress and need for services;

      3. meet program and federal reporting requirements;

      4. obtain admissions/transfer information;

      5. obtain college/university-tracking information.

      I understand that TRIO’s purpose is to increase the retention, graduation, and transfer rates of program members, and agree to participate in related services until I meet my educational goals.

    • Clear
    • Date*
       - -
    • Submit 
    • Should be Empty: