Rogue Community College-EOC-Participation Form

  • STUDENT APPLICATION
    Rogue Community College
    TRiO Educational Opportunity Program
    For questions, please call 541-956-7097

    TRIO Programs are fully funded by the United States Department of Education. All services are free of charge to participants and hosted by Rogue Community College.

    TRiO EOC Participation

    • Student Information 
    • Date of Birth*
       - -
    • County*
    • From September 1, 2025 to today, have you participated in either of these TRIO programs?*
    • Ethnicity: Are you Hispanic/Latino?*
    • Race*
    • Identity: We appreciate your answering this with whatever is most comfortable for you.*
    • Are you proficient in English? *
    • Military Connections
    • Special Services:  I am interested in -
    • I am
    • You are Independent if you can mark at least one of these:
    • Eligibility Criteria 
    • Citizenship*
    • Citizenship*
    • Did either of your parents get a four-year Bachelor’s degree before you were 18?*

    • Income Information

    • Using the choices below select your household's taxable income from the last IRS tax form you submitted. *
    • Academic Need 
    • Is it your intent to go on to earn a 4-year degree from a university?*
    • High School (check one)*
    • College (check one): *

    • Personal Statement, Goals and Needs Assessment

    • Personal Statement: I need more information or assistance with one of the following*
    • because*
    • Needs Assessment: I would like more information about and/or assistance with:*
    • Authorization 

    • I hereby certify that this information is correct to the best of my knowledge. With my signature below, I am verifying the income of my family, granting all TRiO EOC and college personnel access to the information contained on this form, on Institutional Student Information Record (ISIR), and in the RCC system for the purposes of program recording, tracking, and reporting as required by the U.S. Department of Education. I allow TRiO EOC personnel to conduct research pertaining to my educational outcomes as they relate to the TRiO EOC program using phone, email or other digital mediums. It is my intent that this consent form be interpreted to the extent permitted by applicable law, including but not limited to the Internal Revenue Code, the Higher Education Act, and the Family Educational Rights and Privacy Act.

    • Today's Date*
       - -

    • If you are a Dependent, Parent agreement and Name are required: 

    • Today's Date
       - -
    • Submit 
    • Should be Empty: