Bellingham Technical College-SSS-Application Form

  • TRIO Student Support Services Application

  • This program is funded by a US Department of Education grant that requires collecting some demographic information (ethnicity, race, and sex) about the students for whom we provide assistance. The services are free, but we need your cooperation in providing us the following information. Thank you.

    STUDENT INFORMATION

  • Pronouns

  • Date of Birth*
     - -
  • Gender*
  • Text ok?*
  • Are you a U.S. citizen or permanent resident (green card holder)?*
  • Ethnicity (Please choose one)*
  • Race (Please choose at least one):*

  • The TRIO grant enables us to better support students with disabilities. To ensure we can meet the grant requirement to serve students with disabilities, we ask you to check yes if you have a documented disability (If you check yes, we'll refer you to our Accessibility Resources office for accessibility support.) If you do not have a documented disability, please check no.*
  • Are you currently taking classes at BTC?*

  • If yes, we'll refer you to our Accessibility Resources office!

  • Did any one of your parents or guardians receive a bachelor’s degree (4-year college degree)? (If no, congratulations! You’re a first-generation college student!)*
  • Do you have a high school diploma or GED (or equivalent)?*
  • Have you already completed a college degree (AA, BA, etc.)*
  • Do you plan to transfer to a 4-year college or university?*
  • Have you applied for financial aid (FAFSA)?*
  • In addition to attending college, do/will you work?*
  • Are you currently enrolled in any of the following services/programs?*
  • Support Needs (Check all that apply):
  • TRIO Tutoring Services (Check all that apply):

  • Needs Assessment

  • Academics. Check all that apply to you.
  • Tutoring Services. Check all that you are interested in.
  • Major/Career. Check all that apply to you
  • Financial. Check all that apply to you.
  • Wellbeing. Check all that apply to you.
  • Basic Needs. Check all that apply to you.
  • How did you hear about TRIO Student Support Services?

  • I understand...*

  • Bellingham Technical College does not discriminate on the basis of race, ethnicity, creed, color, sex, gender indentity or expression, citizenship or immigration status, national origin, age, religion, disability, veteran or military status, sexual orientation, genetic information, the presence of any sensory, mental, or physical disability or the use of a trained dog guide or service animal by a person with a disability, pregnancy, marital status, or any other characteristic protected by federal, state, or local law in its programs, activities, and services.  The following person has been designated to handle inquries regarding the non-discrimintation policies: Director for Human Resources Allison Mack, 360.752.8354, or hr@btc.edu.  For Title IX/Section 504 compliance, contact: Vice President of Student Services Michele Waltz, 360.752.8440, or title9@btc.edu.  Mailing address: 3028 Lindbergh Avenue, Bellingham, WA 98225.  BTC publications are available in alternate formats upon request by contacting the Accessibility Resources office at 360.752.8576.

  • Clear
  • Date*
     - -

  • By signing this application, I attest that I am the individual named above, and I authorize BTC’s Student Success Programs to review my application and college records (i.e. transcripts, financial aid applications and awards, placement scores, etc.) to determine if I am eligible.

    Click the Next button below to continue to a short new student survey. This will help us better determine how TRIO can support you!

  • To what extent do you agree or disagree with the following statements?

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