College Bound Institute-TS-Application Form

  • Educational Talent Search Program Application

    College Bound Institute
    • STUDENT INFORMATION 
    • Eligibility*
    • School:*
    • Grade:*
    • Gender:*
    • Sex:*
    • Birthdate:*
       - -
    • Ethnic Background:*
    • Are you a citizen of the United States?*
    • Student lives with:*
    • I was referred to ETS by:*
    • ELIGIBILITY CRITERIA - All information must be complete to be eligible for ETS services. 

    • Funding is provided by the US Department of Education and requires specific documentation for enrollment into the TRIO Educational Talent Search Program. The information is protected by the Family Rights and Privacy Act. The information is used to determine if the student is eligible to participate in the ETS program. This section must be completed by the parent/guardian.

    • First Generation Status (Parents' or Guardians' educational level)

    • Please check the highest level of education completed by the student's mother/female guardian:*
    • Please check the highest level of education completed by the student's father/male guardian:*

    • Income Status

    • If your family is using any of the following programs, please check:*
    • Is this student a Ward of the Court?*
    • Taxable Income - Net Adjusted Gross Income (check one- see 1040 tax form, line 43 or 1040A tax form, line 27, or 1040EZ, line 6)*

    • Federal TRIO Programs Current Year Low-Income Levels  Effective 1/22

    • STUDENT ASSESSMENT - THIS SECTION TO BE COMPLETED BY STUDENT ONLY 
    • What are your plans after you graduate from high school?*
    • What services and information would you like to receive from CBI Educational Talent Search? (check all that apply):*

    • If accepted, I agree to always treat myself, other students, and program staff with respect.

      I also agree to work hard in school, participate in ETS sessions, events, and workshops throughout middle and high school, in order to prepare myself for success in school and in college.

    • Date:*
       - -
    • PARENT AGREEMENT - THIS SECTION TO BE COMPLETED BY PARENT ONLY 
    • Parent Agreement*

    • This consent will remain in effect for as long as my child is a participant in ETS.

    • Date:*
       - -
  • Should be Empty: