Piedmont Community College-Roxboro-EOC-High School Application Form

  • TRIO EDUCATIONAL OPPORTUNITY CENTERS (EOC)
    Piedmont Community College
    1715 College Drive, Roxboro, NC 27574
    Telephone:  (336) 599-1181

    EOC High School Student Application Form

  • Student Class*
  • Participant Status*
  • Date of Birth*
     - -
  • Gender*
  • Citizenship Status*
  • Ethnicity*

  • EDUCATIONAL ACHIEVEMENT

  • I have a high school diploma*

  • I plan to obtain a high school diploma:

  • COLLEGE PLANS

  • I plan to _____ college at...*
  • Semester*

  • REQUESTED MATERIALS AND SERVICES (Check all that are applicable.)

  • I need assistance in the following areas:
  • I have already completed:
  • SAT ACT Testing; Interested in retaking?*
  • Student Athlete:*
  • Military*
  • I would like to be considered for the EOC Scholarship!*
  • Are you currently participating in a Talent Search program?*
  • Do either of your parents have a Bachelor’s degree (four-year degree) or higher?*
  • Do either of your parents have an Associate degree (two-year degree) or higher?*
  • Have you been awarded a Pell Grant for college?*
  • What was your family’s taxable income for the previous year?*
  • Agreements*
  • Are you interested in being a part of the PCC Alumni Association?
  • Clear
  • I grant permission for my student to join The Educational Opportunity Center program and to participate in activities it sponsors.*
  • Clear
  • Should be Empty: