• Educational Talent Search Program Application (TS3)-Northridge Local Schools

    • Student Information 
    • Are you a United States citizen?*
    • If no, are you a permanent resident?*
    • Are you an English as a Second Language/ELL student?*
    • Are you a veteran?*
    • Date of Birth*
       - -
      2 digit month, 2 digit day, 4 digit year
    • Gender*
    • Ethnicity (check all that apply)*
    • Do you give ETS permission to text cell #?
    • T-Shirt Size
    • School (2021-2022)*
    • Grade (2021-2022)*

    • Have you completed any classes through the following programs?

    • College Credit Plus*
    • Tech Prep*
    • Are you an Upward Bound participant?*
    • Career Interests (Example: teacher, engineer, accountant, artist)
      Rows
    • Do you receive free or reduced lunch?*
    • Are you experiencing homelessness, in foster care, involved in the juvenile justice system, or neither employed nor enrolled in an educational institution?*
    • I need the following Educational Talent Search program services (check all that apply)*

    • STUDENT AUTHORIZATION FOR RELEASE OF ACADEMIC RECORDS AND INFORMATION

      I submit this information to be considered as a participant in the Sinclair Community College Educational Talent Search program; I certify that the information is true and correct to the best of my knowledge. I release the following information from public school records to the Educational Talent Search program: transcripts, test scores, income, and other information necessary for program application completion, provision of academic support, and verification of student progress. All information provided on this form will be kept confidential and will not be disclosed to a third party by the program without my permission. I understand that my parents/guardians will be required to disclose information, such as household income, necessary to determine my eligibility for program participation.

    • Date*
       - -
      2 digit month, 2 digit day, 4 digit year
    • Parent/Guardian Information & Authorization Form 
    • Do you give ETS permission to text cell #?
    • Number of people living in household*
    • Does either parent have a bachelor's (4 yr.) degree?*
    • Family Taxable Income*
    • Do you receive public assistance benefits? (Disability, social security, SNAP, TANF, etc.)*

    • Parent/Guardian Release Authorization

      By my signature below:

      • I certify that the above information is correct and true to the best of my knowledge.
      • I agree that Sinclair Community College, Educational Talent Search staff, or volunteers associated with the college will not be held liable for any loss, injury, or death related to any field trip, activity, or event.
      • I authorize the Educational Talent Search staff access to any and all academic records/transcripts/social security numbers available from the school the student/applicant attends for the purpose of determining eligibility and providing educational services.
      • I authorize and permit my child to participate in field trips, activities, and events sponsored and conducted by Educational Talent Search.
      • I grant permission for my child to access networked computer services such as the Internet, World Wide Web, and electronic mail.
      • I grant permission to the Educational Talent Search program to use images of my child for the purpose of promoting the Educational Talent Search program and Sinclair Community College.
      • In the event that my child is involved in a medical emergency, I authorize Educational Talent Search staff to make decisions regarding immediate medical attention (hospitalization, administration of prescribed medications, doctor treatment, etc.), if I am unable to be contacted or reached for verbal authorization.
    • Date*
       - -
      2 digit month, 2 digit day, 4 digit year
    • Submit 
    • Should be Empty: