Shasta College-TS-Application Form

11555 Old Oregon Trail - P.O. Box 496006 - Redding, CA 96049-6006

(530) 242-7690 www.shastacollege.edu
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Dear Students and Families,

Thank you for your interest in the Shasta College TRIO Educational Talent Search (ETS) Program!

Before completing the application, we'd like to share a little about what it means to be part of TRIO ETS and how the program can support your educational journey.

The goal of TRIO Educational Talent Search is to help students build the academic skills, confidence, and motivation needed to succeed in middle school, high school, and beyond. Through tutoring, academic support, college and career exploration, and engaging activities, TRIO ETS encourages students to achieve their goals and explore opportunities for higher education and career readiness after high school.

There is no cost to participate. Shasta College TRIO Educational Talent Search is a federally funded program through the U.S. Department of Education that serves 577 students at nine partner schools throughout Shasta County. Students from the following schools are eligible to participate:

Anderson Middle School
Anderson New Technology High School
Anderson Union High School
Happy Valley Elementary School
Pacheco Union Elementary

Tree of Life International Charter School
North Valley High School
West Cottonwood Middle School
West Valley High School

TRIO ETS students are encouraged to actively participate in program activities offered throughout the school year. Most activities are offered at your school site during school hours. These opportunities are designed to help students grow academically, explore future possibilities, and prepare for success after high school.

Program activities include:

Academic tutoring and study support
College and career exploration
Educational workshops
College campus visits and field trips
Financial aid and scholarship information
Academic and college planning

Our program aims to:

Strengthen students' academic skills and performance
Build confidence and motivation for future success
Introduce students to college and career opportunities
Provide enriching educational and cultural experiences
Offer guidance with college admissions and financial aid processes
Support students in achieving their educational goals

If you're interested in becoming a part of the Shasta College TRIO Educational Talent Search Program, please complete the attached application. If you have questions or would like more information, please contact us at (530) 242-7690. We look forward to working with you and helping students reach their academic, college, and career goals!

TRIO Works!

Katie Littlepage

TRIO Director - Pre-College Programs

PARENT/GUARDIAN CONTACT INFORMATION

Rows	Parent 1	Parent 2
Name:
Relationship:
Phone:
Email:
Occupation:
Employer:

a) Student Lives With:

Other
*Please include education information for natural or adoptive parents only
b) Please indicate the highest level of education completed by Parent 1:
b) Please indicate the highest level of education completed by Parent 2:

Please read carefully then sign and date where indicated:
- By signing this application, I certify that all information provided above is true and accurate to the best of my knowledge.
- I/We understand that all information on this application, as well as that released from the school, will be held in strict confidence by the TRIO Educational Talent Search program staff.
- I/We authorize the release of academic records (e.g. copies of school transcripts, test scores, ACT/SAT or GED scores, and school lunch program eligibility) to the Shasta College TRIO Educational Talent Search program in order to assess need/eligibility for program services, discern academic progress, evaluate the effectiveness of program activities, and fulfill program reporting requirements.
- I/We consent to the disclosure of any personally identifiable information as defined by FERPA of my education records to the Shasta College TRIO Educational Talent Search program staff for the purpose of confirmation of the student’s postsecondary enrollment status as reported on the National Student Clearinghouse Student Tracker. This authorization will remain in effect for six years following high school graduation.
- I/We authorize the release and exchange of student financial aid information from colleges and federal government to the TRIO Educational Talent Search program.
- I/We understand there is a zero tolerance policy in regard to blatant or implied gang insignia, dress, hand signs, harassing or threatening behavior, weapons, alcohol, and drugs.
- I/We authorize the TRIO Educational Talent Search program to share and discuss information with school personnel in support of my student’s academic success.
- I/We give permission for the student to participate in activities and field trips supervised by TRIO Educational Talent Search personnel.
- I/We also give permission for the TRIO Educational Talent Search program to take photographs during activities and trips, and grant permission to use the student’s name, comments, and/or photos/videos for educational and/or promotional purposes.
- I/We understand if the student should need accommodation for a disability in order to participate in TRIO Educational Talent Search or any of its scheduled activities, I/we must contact TRIO Educational Talent Search at (530) 242-7690 at least 30 working days prior to the activity.
- I/We understand that this authorization will remain in effect while the student is enrolled in the Shasta College TRIO Educational Talent Search program or until written notice is provided to revoke the authorization.
STUDENT'S PRINTED NAME:

First NameLast Name
STUDENT'S SIGNATURE:
DATE:

MonthDayYear
2 digit month, 2 digit day, 4 digit yearmm-dd-yyyy
PARENT/GUARDIAN PRINTED NAME:

First NameLast Name
PARENT/GUARDIAN SIGNATURE:
DATE:

MonthDayYear
2 digit month, 2 digit day, 4 digit yearmm-dd-yyyy
**Incomplete or unsigned applications will be returned for completion before being considered for enrollment**

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