University Of Texas-El Paso-SSS-Application Form

Student Support Services (SSS) New Student Application
All information provided will be held confidential and used for SSSP Project purposes only.

Participation in other EOPs
Please indicate which Education Programs (EOPS) you have participated in (Check all that apply):

Talent SearchGEAR UPUpward BoundNone/Not applicableOther

Dependent Student - Please have your parent/guardian complete this form
Dependent Student- Under 24 years of age, single, have no children OR children receiving less than half of their support from you.
Parents' Education Attainment & Income Information
Student's Name:

First NameLast Name
Student ID:
Parent/Guardian's Name:

First NameLast Name
Did student's mother graduate from college with a 4-year degree?

YesNo
If Yes, from which university or college:
Did student's father graduate from college with a 4-year degree?

YesNo
If Yes, from which university or college:
Number of people living in parent's household (claimed on taxes)?
What is parent's most recent taxable income* (not adjusted gross income)?
Please write in a dollar amount (Not the year taxes were filed)
* Taxable income is lower than Adjusted Gross Income (AGI) and is listed on all tax forms. Please contact us if you did not or were not required to file a tax form.

All the information on this form is true and complete to the best of my knowledge.
Parent/Guardian Signature:

Clear
Date:

MonthDayYear
mm-dd-yyyy

Independent Student- Please complete this form
Independent Student- Over age 24, married, a veteran or active military, have children who receive more than half of their support from you, OR an orphan or ward of the court.
Education Attainment & Income Information
Student's Name:

First NameLast Name
Student ID:
Parent/Guardian's Name:

First NameLast Name
Did your mother graduate from college with a 4-year degree?

YesNo
If Yes, from which university or college:
Did your father graduate from college with a 4-year degree?

YesNo
If Yes, from which university or college:
Number of people living in your household (claimed on taxes)?
What is your most recent taxable income* (not adjusted gross income)?
Please write in a dollar amount (Not the year taxes were filed)
* Taxable income is lower than Adjusted Gross Income (AGI) and is listed on all tax forms. Please contact us if you did not or were not required to file a tax form.

All the information on this form is true and complete to the best of my knowledge.
Independent Student's Signature:

Clear
Date:

MonthDayYear
mm-dd-yyyy

Student Support Services (SSS) New Student Application