Broward College-ESL-SSS-Application Form

  • BROWARD COLLEGE

    TRIO STUDENT SUPPORT SERVICES ESL APPLICATION

    Student Support Services (SSS) is a learning community that offers members free comprehensive academic support services to enhance their performance and promote academic success. Our goal is to retain and graduate students who are first generation, low‐income and/or have a disability. SSS is a grant funded program through the U.S. Department of Education.

    Eligibility Requirements 
    A student must meet one of the following eligibility criteria in addition to being a United States citizen or Permanant Resident of the United States:

    • Be a first-generation college student (neither parent has a Bachelor’s degree)
    • Limited income individual (verified by a SSS staff member) and/or
    • Have a documented learning or physical disability 

    Additionally, students must ​be enrolled in English for Academic Purposes (EAP) classes, a non-native English speaker, or speak in another language at home.

    WHEN SHOULD I APPLY?

    Immediately! Applications are accepted throughout the year, but program size is limited. Your responses are necessary to determine program eligibility and will be kept confidential.

    If you have questions or need assistance with the application, please email SSS@broward.edu

     “The mission of TRIO Student Support Services is to provide unique and personalized academic support services in an environment that inspires engaged learning.”

    How can SSS help?

    • Advising:
      • Course Selection
      • Registration Assistance
      • Choosing Majors and Careers
      • Developing an Individual Graduation Plan
      • Baccalaureate Transfer  Planning
    • Financial Assistance:
      • FAFSA Forms
      • Scholarship Applications
      • Grant‐Aid and Scholarships
      • Financial Planning
      • Economic Literacy Workshops
      • Instruction:
      • Workshops and Classes
      • Tutoring
      • Writing, Math and Reading/Study Skills Assistance
    • Resources:
      • Resource room with Computers and Printer

  • This application will determine whether you are eligible to receive services provided by the Student Support Services Program (SSS). This information will be kept CONFIDENTIAL.

    • Personal Information 

    • Telephone Numbers

    • Date of Birth*
       - -
    • Marital Status
    • Gender*
    • What is your citizenship status?*

    • Ethnic Background
    • Do you identify as Hispanic/Latino?*
    • Please select the ethnicity/race below with which you identify. You may select more than one. *
    • Program Eligibility 
    • Do your parents (natural or adoptive)/guardian have a Bachelor’s degree from the United States?*
    • Income

    • *This Low-Income Level limits chart refers to Taxable Income. Taxable income is found on line 15 of Form-1040 tax return.

      Based on the chart above, using the number of people in your home (family size) and the total taxable income of the workers in your home:

    • Are you considered low-income?*
    • Have you applied for financial aid at Broward College?
    • Have you taken out any student loans?*
    • Do you have a documented disability for which you are requesting services?*
    • Are you an English for Academic Purposes (EAP) student?*
    • Are you currently enrolled on a Health Science Pathway?
    • Have you participated in a TRIO program in the past?
    • If yes, check all that apply
    • Educational Background 
    • Are you a High School graduate?
    • What BC campus are you enrolled in?*
    • What is your current Academic Pathway at Broward College?*
    • Current Class Standing:

    • Interview 
    • What services/resources could TRIO SSS ESL assist you with? (select all that apply):

    • Please select any personal concerns affecting success. (Select all that apply)
    • How were you recommended to TRIO SSS ESL?

    • Educational Goals 
    • What are your future college plans?*
    • How were you recommended to TRIO SSS ESL?

    • Service and Resources (check all in which you are interested)

    • I would like SSS to help me with

    • Participation Requirement 

    • I understand that the goal of TRIO Student Support Services (SSS) ESL is to enhance my educational experience here at Broward College through personal counseling, workshops, and cultural excursions. Accepted TRIO SSS ESL participants are required to complete the following each semester:

      • 3 Coaching Sessions
      • 2 Workshops
      • 1 Cultural Activity
         

      I hereby affirm that I will complete the above services to the best of my ability to maintain “Active Participant Status” within the TRIO Student Support Services ESL Program at Broward College. Should I become unable to meet the expectation, I risk the chance of being removed from the program.

    • Affidavit of Truth Statement 

    • I hereby authorize the release of my records in reference to academic transcripts, degree plans, personal assessment scores, financial aid, and any other pertinent information related to my academic endeavors to the Student Support Services staff of Broward College.

    • We like to recognize student achievements. Do you grant permission to include your name and/or picture for program related publicity, exhibits or displays? Please indicate preference(s):*

    • I hereby certify that the information provided is true and complete to the best of my knowledge. I understand any false information given will result in the loss of participation opportunity.

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