Mount Wachusett Community College-EOC-Application Form

  • North Central Educational Opportunity Center

    Participant Application
  • Todays' Date
     - -
  • How can the North Central Educational Opportunity Center (EOC) assist you?

    • Applicant Information 
    • Gender*
    • Date of Birth*
       - -
    • Do you identify yourself as Hispanic or Latino?*
    • If no, check all that apply:*
    • Are You a U.S. Citizen?*
    • If no, Are you an eligible non-citizen?*
    • Browse Files
      Cancelof
    • If No, Are you in the U.S. for other than temporary purpose*
    • Browse Files
      Cancelof
    • What is Your Marital Status?*
    • Are you a veteran of the Armed Forces of the United States?*
    • Are you currently on active duty in the Armed Forces for other than training purposes? (Answer “No” if you are a National Guard or Reserves enlistee who is on active duty for state or training purposes.)*
    • Do you have a spouse who is currently serving active duty in the Armed Forces?*
    • Do you have a parent or legal guardian who is currently serving active duty in the Armed Forces?*
    • What is Your Military Affiliation?*
    • Which parent did you regularly reside with and receive support from during your childhood (i.e. until age 18)?*
    • Did your mother (birth or adoptive) graduate from a four year college or university?*
    • Did your father (birth or adoptive) graduate from a four year college of university?*
    • What is your current level of education? (Check ALL that apply to you)*
    • Employment and Income Information 
    • What is your current employment status?*
    • Last year's income source (check all that apply to you/your spouse).*
    • Did you file a U.S. income tax return last year?*
    • What was your income tax filing status?*
    • Are you currently receiving TANF (Temporary Assistance for Needy Families)?*
    • Are you currently receiving SNAP (Supplementary Nutrition Assistance Program)?*
    • Dependency Questions 
    • Will you be 24 or older by December 31st of this year?*
    • Are you married?*
    • Are you enrolling in a Master’s or Doctoral degree program this year?*
    • Do you have children who receive more than half of their support from you?*
    • Do you have dependents (other than your children and/or spouse) who live with and receive more than half of their support from you?*
    • Are you a Veteran of the armed forces?*
    • Are you currently serving active duty in the U.S. armed forces (excluding reserves)?*
    • Were you an orphan, ward of the court or in foster care at any time since you turned 13 years old?*
    • Are you an emancipated minor as decided by a court in your state of legal residence?*
    • Are you homeless or at risk of being homeless as determined by (a) your high school or district homeless liaison, (b) the director of an emergency shelter or transitional housing program, or (c) the director of a runaway or homeless youth basic center or transitional living program?*
    • Parent Income Information 
    • Did your parent(s) file a U.S. income tax return last year?*
    • What was your parent(s) income tax filing status?*
    • Are your parent(s) currently receiving TANF (Temporary Assistance for Needy Families)?*
    • Are your parent(s) currently receiving SNAP (Supplementary Nutrition Assistance Program)?*

    • Participant Employment and Income Information (including spouse, if married)

    • Have you/your spouse had any decrease in your income this year?

    • Participant Employment and Income Information

    • What is your current employment status?
    • Last year’s income source (check all that apply to you).
    • Did you file a U.S. income tax return last year?
    • What was your income tax filing status
    • Have you had any decrease in your income this year?

    • Parent(s) Employment and Income Information

    • What is your parent(s) current employment status?
    • Last year’s income source [check all that apply to your parent(s)].
    • Have your parent(s) had any decrease in income this year?
    • Certification and Release 

    • I hereby authorize the North Central Educational Opportunity Center (NCEOC) to disclose and/or receive access to the following types of information from my education records for the purpose of receiving services from the NCEOC and for mandatory reporting requirements to determine program effectiveness.  Services may include completing the Free Application for Federal Student Aid (FAFSA), college applications and participating in workshops that promote planning for, applying, enrolling and persisting in post-secondary education and training.  This information will include, but is not limited to, FAFSA data, such as the Student Aid Report and other documentation reflecting FAFSA completion or National Student Loan Data System (NSLDS) information, documentation verifying high school graduation or equivalent secondary school completion documents such as diplomas and transcripts, and evidence of college application completion via Banner, National Student Clearinghouse, and other applicable databases, acceptance letters, unofficial transcripts, schedules, verification e-mails, and other documents needed for the NCEOC program to meet reporting requirements from the U.S. Department of Education.

      My signature below certifies that the above information is correct to the best of my knowledge, that the below signature(s) belong to the intended party and is not forged, that I have a desire to pursue a program of postsecondary education (HEA SEC 402F & CFR 644.3 (a)(3)), and that I am in need of support to successfully pursue/complete a program of postsecondary education.

    • Please click Next to submit your application.

    • Submit 
    • Should be Empty: