• TRiO Student Support Services
    PATHWAYS TO SUCCESS PROJECT
    Georgia State University Perimeter College, Newton
    Application for Participation

    Please submit your SSS application by as soon as possible for the best chance of securing a place in this highly competitive program! Applications are accepted past this date until the program is full. Updates regarding the status of a student’s application are sent to the GSU e-mail account. PLEASE make sure your application is complete upon submission to avoid a delay in consideration. If you have any questions about the TRiO SSS program and/or the application process, feel free to contact the SSS office at sssnewton@gsu.edu.

    • Contact and Personal Information 
    • Gender*
    • Gender: How do you identify?*
    • Date of Birth*
       - -
      2 digit month, 2 digit day, 4 digit year
    • Communication Information 
    • Do you agree to accept and receive SSS program text messages?*
    • What is your preferred method of communication?*
    • Race/Ethnicity/Citizenship Information 
    • Are you a U.S. Citizen or permanent resident? *
    • Do you identify yourself as Hispanic or Latino?*
    • Choose one or more races that you consider yourself to be (the grant requirements from the U.S. Department of Education require you to select at least one race category): *
    • Qualification Information 

    • Please remember that you must meet at least one of the following to qualify for services.

      *First Generation Qualifications: Complete only for parent(s) or guardian(s) who you primarily lived with while attending high school.

    • Have either of your parents/guardians earned and received a bachelor’s degree? *

    • Disability Qualifications: Student Disability Status (voluntary)

    • Do you have a disability?
    • Have you met with Access & Accommodations Services regarding accommodations? *

    • Low-Income Qualifications

    • Have you applied for Financial Aid? *
    • If yes, did you receive a Pell Grant?
    • Military Connection Information 

    • Veteran Status

    • Are you a member of the U.S. Armed Forces? *
    • Are you a member of the U.S. Reserve Forces*
    • Are you a child or spouse of a military-connected person? If so, please check the appropriate box below
    • Educational Information 
    • Did you earn a high school diploma? *
    • Did you earn a GED?
    • Have you completed a bachelor’s degree?
    • What is your academic classification for the upcoming school year?*
    • Are you*
    • Are you (Check all that apply)*
    • Were you a TRiO participant at another school? *
    • If so, check all that apply
    • When did/will you start at Georgia State University’s Perimeter College, Newton?*
      Rows
    • Attendance at Perimeter College-Newton? *
    • Do you intend to earn a bachelor’s degree? *
    • Do you intend to graduate from Georgia State University’s Perimeter College-Newton? *
    • Living and Financial Information 
    • Have you ever been in foster care or in a court appointed guardianship? *
    • If yes, were you in foster care after the age of 13 years old?
    • Do you have a fixed, regular and adequate night-time residence? *
    • Check the amount below which best matches your household’s current level of taxable income: (This amount can be found on tax forms 1040-line 11b)*
    • Have you applied for Financial Aid (FAFSA) for the current academic year? *
    • Which categories of Financial Aid do/will you receive? (check all that apply)*
    • Academic Needs (Self Report) 
    • In addition to meeting with your TRiO SSS Education Program Specialist, you will be required to participate in other programs/events. Of the following programs/workshops, please indicate which would be most interesting or helpful to you. Please check all that apply and you will discuss further with your EPS.
    • How did you hear about TRiO Student Support Services at Newton?*
    • Release of Information 
      • I give my SSS Director and Education Program Specialists permission to communicate with professors/advisors/tutors and other GSU Perimeter College-Newton professionals to discuss academic information.
      • I give permission to release my name for recognition purposes (scholarships, awards, etc.).
      • I understand that completion of this application does not constitute acceptance into the TRIO Student Support Services program. I also understand that if I am accepted, I will be assigned to a TRIO SSS Education Program Specialist, will be encouraged to take advantage of tutoring, academic advising, and workshops; participate in educational and cultural opportunities. Program participation is necessary to remain in the program.
      • I hereby give permission for TRIO SSS staff to disclose and receive information concerning the nature of my eligibility and information concerning my academic progress on an as-needed basis with appropriate faculty and staff at Georgia State University Perimeter College, Newton. I also give TRIO SSS staff permission to photograph me for promotional purposes, to view and receive any/all financial aid information, as well as receive information from past, current, and future schools. By initialing and submitting this application I am signifying that I have read and understood this application, and that what I have reported is truthful and accurate.
    • Date
       - -
      2 digit month, 2 digit day, 4 digit year
    • Status
    • Submit 
    • Should be Empty: