Passaic County Community College-STEM-SSS-Application Form

  • PASSAIC COUNTY COMMUNITY COLLEGE

    Student Support Services - STEM

    Program Application

  • The Student Support Services – STEM (SSS - STEM) Program provides academic and financial support to eligible STEM and Health Sciences students at English levels DE 020 and above and Math levels MA 025 and above to earn a certificate and/or an Associate's Degree at PCCC. Students must be a STEM or Health Sciences major who have a demonstrated need for academic support. Students must be a first-generation college student; meet the federal low-income guidelines; OR be an individual with disabilities registered through the Office of Disability Services (ODS).

    • APPLICANT INFORMATION 
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    • ELIGIBILITY 
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    • PROGRAMS YOU HAVE PARTICIPATED IN 
    • EDUCATIONAL INFORMATION 
    • INCOME VERIFICATION 

    • If you are a dependent student, please use your parent/guardian's income information and your own income information if applicable.
      If you are an independent student, please use your own income information.

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    • You have chosen to submit an Income Verification Form, please choose the appropriate form below:

      If you indicated that you are a DEPENDENT student, please follow this link to complete the form: https://botform.compansol.com/222374104008848

      If you indicated that you are an INDEPENDENT student, please follow this link to complete the form: https://botform.compansol.com/222373513604853

      **NOTE: The Income Verification Form MUST be completed and submitted BEFORE you submit this application if this is your chosen method of income verification.

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    • PROGRAM SERVICES 
    • AUTHORIZATION 

    • I authorize the SSS-STEM Program to obtain, copy, review, and discuss my records including:

      • High School Transcript
      • Transcripts from Other Colleges
      • Financial Aid Records
      • Standardized Test Scores
      • Course Registration for Each Semester
      • Academic Progress
      • Final Grades and Transcripts
      • Disability Documentation

      I authorize use of my name and photograph to be published in the Student Support Services - STEM publications. I certify that the information I have provided on this application is true and complete to the best of my knowledge. I understand that if found that I intentionally misrepresented myself, it is sufficient cause for dismissal from the SSS – STEM Program. I consent to receiving communication from the SSS – STEM Program through telephone calls, texts, and e-mail messages. I understand this information will be used in complete confidence. With my signature, I am acknowledging that if accepted as a participant in the SSS – STEM Program or waitlist, I agree to meet all program obligations.

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    • CONTACT INFORMATION

    • Student Support Services - STEM Program

      Email: sssstem@pccc.edu

      Passaic County Community College

      One College Boulevard, Paterson, NJ 07505

       

      Ms. Jihan Ahmed, Director

      Office: E204

      Phone: 973-684-5661

      Email: JAhmed@pccc.edu  

       

      Ms. Janet Castillo, Success Coach

      Office: S203

      Phone: 973-341-1618

      Email: jcastillo3@pccc.edu 

       

      Ms. Allison Stanich, Program Assistant

      Office: E201

      Phone: 973-684-7717

      Email: astanich@pccc.edu

    • REQUIRED APPLICATION DOCUMENTS

      • Completed SSS – STEM Program Application (this completed document)
      • Income Verification (MOST RECENT Income Tax Return [Form 1040], signed FAFSA SAR, or signed Dependent/Independent Verification Sheet)
      • Copy of PCCC Student ID, Driver's License, Passport, or other government-issued photo ID
      • Copy of Permanent Resident Card if not a U.S. citizen
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