North Central State College-SSS-Application Form Logo
  • Student Support Services Application

    NC STATE COLLEGE TRiO - 419.755.9015 - triosss@ncstatecollege.edu - www.ncstatecollege.edu/student-services/trio
    • APPLICATION INSTRUCTIONS 
    • TRiO Student Support Services is a federally funded program through the U.S. Department of Education that provides additional support and resources to students who apply and are accepted.  Please complete this application in its entirety.  The information you provide is strictly confidential.  Upon receipt of your application, a member of our Trio team will contact you to schedule an appointment.

    • DEMOGRAPHIC INFORMATION 
    •  - -
    • Browse Files
      Drag and drop files here
      Choose a file
      Cancelof
    • ACADEMIC INFORMATION 
    •  - -
    • PROGRAM ELIGIBILITY 
    • If you DID NOT CHECK any of the above, you are considered a DEPENDENT student and must submit your parents or guardians signed Federal Income Tax Return for 2021. Otherwise, you are considered an INDEPENDENT student and must submit your signed Federal Income Tax Return for 2021.

    • Browse Files
      Drag and drop files here
      Choose a file
      Cancelof
    • FINANCIAL ELIGIBILITY 
    • TAXABLE INCOME: It is very important you indicate TAXABLE INCOME and not total income or adjusted gross income. The best source for this information is your 2021 Federal Income Tax Return. Taxable income is reported on: line 43 of form 1040; line 27 of 1040A; or line 6 of 1040EZ. (If you do not have a copy of your Federal Income Tax Return, visit http://www.irs.gov/Individuals/Get-Transcript where you can obtain a copy of your Tax Transcript online - NOTE: You will need to create an account on that website)

    • Browse Files
      Drag and drop files here
      Choose a file
      Cancelof
    • FAMILY SIZE: If you live with your parents, include them, yourself, siblings, and any other person supported by your parents. If you are independent, include yourself, spouse, children, and any other person supported by you.

    • I certify the information I provided on this application is, to the best of my knowledge, true and accurate. By applying to this program, I authorize TRIO Student Support Services to access information pertinent to my participation from other NCSC departments. Also, I recognize that completing this application does not guarantee my admission to the program.

    • Clear
    •  - -
    • (Parent signature is NOT needed if the student is independent.)

    • Clear
    •  - -
    • *TRIO Student Support Services is 100% federally funded at $253,032 through the U.S. Dept. of Ed.

    • Needs Assessment Survey 
    • My most important areas which I will need assistance are: (check all that apply)

    •  
  • Should be Empty: