Lone Star College-North Harris-TS2-Application Form

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Thank you for your interest in TRIO Educational Talent Search!

TRIO Educational Talent Search (ETS) is a program designed to help students prepare for college. All program services are free. We provide academic advising, college tours, cultural activities, assistance with scholarship applications, and more.

To apply, please complete this application and submit along with supporting documents to our office via email. All information will be kept confidential and used only to determine eligibility for the program.

Items Needed for Application Packet to be Considered Complete:

1) Completed TRIO ETS Application
2) Copy of Student’s Most Recent Grades, Progress Report, Report Card, or Transcript
3) Birth Certificate, U.S Passport, or Certificate of Citizenship

If you have any questions, please let us know and we will be happy to help.

Sincerely,

TRIO Educational Talent Search Staff
Lone Star College–North Harris
Office Phone:
Email:
Website: www.lonestar.edu/talentsearch

Lone Star College–North Harris TRIO Educational Talent Search is 100% federally funded by the U.S. Department of Education
Please upload a copy of your Transcripts/Grades

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Student Information
Name:*

First NameM.ILast Name
Student ID #:*
School:*
School:*
Grade Level:*
Age:*
Date of Birth:*

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

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Student Phone #:*
(999)999-9999
Student Email:*
example@example.com
Are you Hispanic or Latino?*

YesNo
Please select your race/ethnic background.*

American Indian or Alaska NativeAsianBlack or African AmericanHispanic or LatinoNative Hawaiian or Other Pacific IslanderTwo or more racesWhite
What is the primary language spoken at home? *
Student T-Shirt Size:*
What special services are you receiving in school? (ex: ESL, Gifted & Talented, Special Education, Dual Credit)*
Are you in any other TRIO Program (for ex: Upward Bound)*
Did someone refer you to ETS? If so, List their name and their relationship to you.*
If you have a sibling in TRIO ETS, please list their name:*

Parent/Guardian Signature
By signing or typing 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 LSCNorth Harris TRIO Educational Talent Search Program to obtain transcripts and any educational records that pertain to my child’s academic progress. I also give my consent to use my child’s photo for TRIO ETS program advertising. If my child is accepted into the program, I will strive to ensure that my child maintains an active TRIO ETS participant.
Parent/Guardian Signature:*

Clear
Date:*

MonthDayYear
mm-dd-yyyy

Student Signature
By signing or typing 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 ETS program, I will strive to continually improve my academic performance and maintain an active TRIO ETS participant.
Student Signature:*

Clear
Date*

MonthDayYear
mm-dd-yyyy