Alpena Community College-South-TS-Application Form

  • Application Form

    • Student Information 
    • Phone Type*
    • Date of Birth*
       - -
    • Gender*
    • Racial Group*
    • U.S. Citizen:*
    • Do you have a physical handicap or learning disability?*
    • Parent/Guardian Information 

    • Parent/Guardian # 1 should be the custodial parent/guardian

    • Phone 1 Type*
    • Phone 2 Type
    • Phone 1 Type
    • Phone 2 Type
    • Do either of the applicant's parents, with whom they now reside or resided with before becoming independent hold a 4 year degree from a university?*
    • How did you hear about our program?*

    • Don’t forget to apply for other children in grades 6 thru 12 that you would also like to have TTS services (not currently enrolled in TTS).

    • Household Information 
    • Does the Applicant have Medical Coverage?*
    • Are you employed at this time?*
    • Is the applicant a ward of the state?*
    • Is the applicant in foster care?*
    • Is the applicant homeless?*
    • Please indicate if you are receiving any of the following services?*
    • TRiO Talent Search Services Offered 
    • Please check the services you would like the applicant to receive*
    • Additional 
    • Does the applicant participate/qualify for the school's FREE/REDUCED lunch program?*

    • You will need to supply a copy of your income verification with this application. Acceptable types are as follows: Current Federal IRS income tax forms (Federal 1040), benefit statements from Dept. of Social Services, Social Security, Veterans, Pension, or Unemployment. Please send only the pages of your 1040 form which shows the number of dependents (p1) and states your household’s taxable income (line 15). Do not send more than pages 1&2.

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    • I certify that all the information on this form is true and complete to the best of my knowledge. I authorize the TS Program to obtain and review any academic, financial, disability, demographic information, or documentation (including eligibility of free or reduced meals programs) from school districts needed for the purposes of data collection and reporting, or progress monitoring, both at the time of my application and throughout my participation in the program.

      I authorize my school district to share information regarding my child’s participation in the Free/Reduced Lunch program for the purpose of income verification for the TS program.

      I authorize the participants photograph to be used in publication and media posts by the Talent Search program.

      I understand that the Talent Search program may use the contact information supplied on this form to contact me/my child by text and email.

      I am also aware that the personal information provided to the Talent Search Program will be protected under the Family Education Rights Privacy Act of 1974.

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    • Clear
    • Date signed*
       - -
    • Submit 
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