Lone Star College-Tomball-TS-Application Form

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Thank you for your interest in Lone Star College Tomball’s TRIO Talent Search Program!

Please review the checklist below to ensure that you have all of the required documents in order to complete the application online.
1. Picture of Student's Most Recent Grades, Progress Report, Report Card, or Transcript
2. Picture of Student's Birth Certificate, Passport, or Permanent Resident Card
If you have any questions, please let us know and we will be happy to help.

Sincerely,

TRIO Talent Search Staff
Lone Star College Tomball
Office Phone: 281-655-3619
Email: TC-TRIOTS@lonestar.edu

Student Information
Name*

FirstM.I.Last
Student High School or Intermediate School ID Number*
School*
School*
Grade Level*
Grade Level*
What year will you graduate high school?*
Age*
Date of Birth*

MonthDayYear
mm-dd-yyyy
Gender*
Gender*
Mailing Address*

Street Address (Include Apt # if Applicable)

Street Address Line 2

CityState / Province

Postal / Zip Code
Student Phone # (If Applicable)
(999)999-999
Student's School Email Address*
example@example.com
Student's Personal Email Address
example@example.com
Are you Hispanic or Latino?*

YesNo
Please select your race/ethnic background.*

American Indian or Alaska NativeBlack or African AmericanNative Hawaiian or Other Pacific IslanderWhiteAsianHispanic or LatinoTwo or more races
What is the primary language spoken at home?*
Student T-Shirt Size (Adult Sizing)
What services are you receiving in school? (for ex: Dual Credit, Advanced Placement, English as a Second Language, or Special Education)
Did someone refer you to the Tomball TRIO Talent Search Program? If so, List their name and their relationship to you.
If you have a sibling in the Tomball TRIO Talent Search Program, please list their name.

Student Citizenship
Are you a U.S. Citizen or National or a Permanent Resident of the U.S.? If you are not a U.S. Citizen/National or U.S. Permanent Resident please contact the TRIO TS office to determine if you meet the Department of Education citizenship requirements for the program.*

I am a United States Citizen/NationalI am a Permanent Resident of the United States

Parent/Guardian Information
With whom does the student primarily live?*
Is the student currently in foster care?

YesNo
Parent/Guardian #1
Name*
Relationship*
Parent Phone*
(999)999-9999
Parent Email*
example@example.com
Bachelor's Degree Received?*

YesNo
Parent/Guardian #2 (If you only live with Parent/Guardian #1, skip this section)
Name
Relationship
Parent Phone
(999)999-9999
Parent Email
example@example.com
Bachelor's Degree Received?

YesNo

Parent/Guardian Income Information
Are you currently a homeless youth?

YesNo
Does your child qualify for the Free/Reduced Lunch Program?*

YesNo
Please check only one box and fill in the information below for the most recent tax year.*

I filed taxes for the year belowI did not file taxes for the year below
Tax Year*
What was the total number of people living in your household for this tax year?*
Total TAXABLE Income - Do not report your gross or total income. The taxable income is the amount after deductions that may be found on your 1040 tax returns. See line 15 of your 2020 or 2021 taxes*
Total TAXABLE Income - Do not report your gross or total income. The taxable income is the amount after deductions that may be found on your 1040 tax returns. See line 15 of your 2020 taxes.*

Parent/Guardian Signature
By signing my name on the signature line below, I certify that the information in this application is complete and accurate to the best of my knowledge. I understand that this information will be used to verify eligibility and to provide data in compliance with federal regulations. I understand that falsification of information may be subject to legal action. I also give my consent to allow the Lone Star College Tomball TRIO Talent Search Program to obtain transcripts and any educational records that pertain to my child’s academic progress. I also give my consent for my child’s captured photography, videotape, or digital image to be used. This includes but is not limited to print, internet, video, or digital publication, and waive any rights to compensation in any form. I understand that Lone Star College is not required to obtain my permission to reuse or republish this image, video, and or audio recording in the future. If my child is accepted into the program, I will strive to ensure that my child maintains an active TRIO TS participant.
Parent/Guardian Signature*

Clear
Date

MonthDayYear
mm-dd-yyyy

Student Signature
By signing my name on the signature line below, I certify that the information in this application is complete and accurate to the best of my knowledge. I understand that this information will be used to verify eligibility and to provide data in compliance with federal regulations. I understand that falsification of information may be subject to legal action. If accepted into the TRIO TS program, I will strive to continually improve my academic performance and maintain an active TRIO TS participant. I also give my consent for my captured photography, videotape, or digital image to be used. This includes but is not limited to print, internet, video, or digital publication, and waive any rights to compensation in any form. I understand that Lone Star College is not required to obtain my permission to reuse or republish this image, video, and or audio recording in the future.
Student Signature*

Clear
Date

MonthDayYear
mm-dd-yyyy

File Uploads
All information will be kept confidential and used only to determine eligibility for the TRIO ETS program.
Picture of Student's Most Recent Grades, Progress Report, Report Card, or Transcript

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Picture of Student's Birth Certificate, Passport, or Permanent Resident Card

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