246679-College Of The Desert-TS-Application Form

246679-College Of The Desert-TS-Application Form

Language

English (US)
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- Legal Name*
  
  First NameLast NameMiddle Initial
- Home Address*
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip Code
- Home Phone*
  (999)999-9999
- Student Cell*
  (999)999-9999
- YesNo
- MaleFemale
- Birthdate*
  
  MonthDayYear
  MM-DD-YYYY
- Email Address*
  example@example.com
- Desert Hot Springs HSDesert Springs MSPainted Hills MS
- 6789101112
- Current G.P.A.*
- Student I.D. Number*
- Race/Ethnicity
- YesNo
- American Indian or Alaskan NativeAsianBlack or African AmericanNative Hawaiian or Other Pacific IslanderWhiteOther
- I agree that if I am accepted into the TRiO Educational Talent Search (ETS) program I will:
  1. Attend all ETS meetings, advising sessions, and/or tutoring sessions which are recommended to me
  2. Attend school regularly and work to maintain at least a 2.5 GPA or higher/ be in good academic standing
  3. Cooperate and behave in a mature, responsible way with ETS staff, mentors, tutors, and other ETS students
  4. Provide follow-up information to ETS staff concerning my academic success
  By signing my name, I agree to follow the above rules and understand that violation of these rules may result in dismissal from the ETS program.
- Student Signature*
  
  Clear
- Date*
  
  MonthDayYear
  MM-DD-YYYY
- The following section must be completed by the parent/legal guardian. This information will de-termine your child’s eligibility for the program. All information will be kept confidential.
- US CitizenPermanent Resident
- Social Security Number
  999-99-9999
- if a permanent resident, please provide Resident Alien number:
- Current Performance Partnership Pilots (P3) provisions have waived the citizenship requirements until September 30, 2026 for eligibility to participate in the program.
- Parent Educational Level
- YesNo
- YesNo
- Income Status
- How many people live in your household (including yourself)*
- What was your family’s taxable income from the last calendar year?*
- Contact Information
- Mother/ Guardian Contact Information:
- Name*
  
  First NameLast Name
- Primary Phone*
- Email*
  example@example.com
- Father/ Guardian Contact Information:
- Name*
  
  First NameLast Name
- Primary Phone*
- Email*
  example@example.com
- I grant my child permission to participate in the TRiO—Educational Talent Search (ETS) program and receive the free services provided. I agree to encourage my child to do well in school, be an active member of ETS, graduate from high school, and pursue a post-secondary education. I also give ETS program staff permission to access my child’s school transcripts, progress reports, standardized test scores, SAT/ACT test scores, and any other infor-mation which is necessary for assessing the participant’s progress in the program up to six years post high school graduation. In addition, I grant TRIO Educational Talent Search program to use my child’s pictures from fieldtrips and other activities for promotional and/or educational program publication materials (e.g. brochures, flyers, web-sites, etc.).
  
  By signing my name, I certify that each response in this application is true and complete to the best of my knowledge. It also indicates that I acknowledge and give consent to the requests of the ETS program.
- Parent/Guardian Name*
  
  First NameLast Name
- Parent/Guardian Signature*
  
  Clear
- Date*
  
  MonthDayYear
  MM-DD-YYYY

- Please verify that you are human*
- Should be Empty: