Delaware Technical & Community-George-TS-PreApplication Form

Delaware Technical Community College-Owens Campus TRIO Program Preapplication Form

Section 2-Financial Information
Please select the total ANNUAL taxable income indicated on your 2022 income tax return*

Under $12,000$12,000-$24,999$25,000-$39,999$40,000-$59,000$60,000 or higher
Total number of dependents living in the household*
*For purposes of documenting participant's low-income status, the Department of Education requires verification of family income from a government source. Please upload a copy of your filed 2022 Federal Income Tax Return.

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References
Please list two teachers and a school counselor that can provide a short recommendation for you.
Teacher Name ( First and Last)*

First NameLast Name
Teacher Email*
example@example.com
Teacher Name (First and Last)*

First NameLast Name
Teacher Email*
example@example.com
Counselor Name ( First and Last )*

First NameLast Name
Counselor Email*
example@example.com
TRIO Program Survey*
School District Attending*

Indian River School DistrictLaurel School DistrictSeaford School DistrictWoodbridge School District
Which program(s) are you interested in*

Educational Talent SearchUpward BoundUpward Bound Math & Science
Educational Talent Search- The goal of the program is to prepare students to be competitive and eligible applicants for a post-secondary institution upon graduating from high school. Students accepted into the ETS program will join a community where they will be supported and encouraged to succeed personally and academically through the program's efforts of academic, career, and college support until high school graduation. Students will attend weekly meetings, educational field trips, college tours, and summer programming.

Upward Bound- Upward Bound gives the high school student an opportunity to learn first-hand what college life is all about and helps the student to develop the skills necessary to succeed in college. The program emphasizes reading, writing, math, study skills, and science. Courses are taught by skilled instructors whose primary concern is the student. Personal, career and academic counseling is also provided. Students participate in Saturday Academies. A six-week summer program that includes a variety of academic, social, and cultural activities. Students have the opportunity to attend educational field trips and college visits. All program services are free and students receive a small stipend for their participation

Upward Bound Math & Science- The goal of Upward Bound Math Science is to help students recognize and develop their potential to excel in math and science and to encourage them to pursue postsecondary degrees in those subjects. Students participate in hands-on and exploratory science activities, as well as work in research labs. Students participate in Saturday Academies. A six-week summer program that includes a variety of academic, social, and cultural activities. Students have the opportunity to attend educational field trips and college visits. All program services are free and students receive a small stipend for their participation

Certification
I understand that by filling out this form I may or may not be accepted into a TRIO program based on the information provided and program qualifications.
Student Signature*

Clear
Date*

MonthDayYear
mm-dd-yyyy
I certify that the information provided in this form is true and correct to the best of my knowledge.
Student Signature*

Clear
Date*

MonthDayYear
mm-dd-yyyy
Parent Signature*

Clear
Date*

MonthDayYear
mm-dd-yyyy

Academic Monitoring

Academic Monitoring

	Username	Password	I am unaware of this information and I give permission to the CUB program to retrieve this information for me/my child from my school
Home Access
Schoology
Clever
Collegeboard.org

Delaware Technical Community College-Owens Campus TRIO Program Preapplication Form