Delaware Technical & Community-George-TS-2023 Application Form

Educational Talent Search Application
Part 1: Student Information
Name*

First NameMiddle InitialLast Name
Student ID Number
Gender
Academic advisingMentoringAssistance with college admissionTest PreparationTutoringConfidence building/social skillsCollege and Cultural VisitsStudy skills/time managementCareer AwarenessFinancial/economic literacyCollege scholarship application processes
Email*
example@example.com
Student’s Social Security Number*
999-99-9999
Date of Birth*

MonthDayYear
mm-dd-yyyy
MaleFemale
Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Current Grade*
School You Attend*
Student Cell Phone Number*
(999)999-9999
Student Home Access Log-In Username:*
Student Home Access Log-In Password:*
Ethnicity/ Race
YesNo
American Indian/ Alaska NativeAsianBlack/African AmericanWhiteNative Hawaiian/Pacific Islander
Please answer each of the following questions:
YesNo
If the student is a permanent resident, what is the alien registration number? *
YesNo
If not, what other language?*
Student was referred by
PART II. Parent/Guardian Information
Disclosure Statement: Educational Talent Search is required by the U.S. Department of Education to obtain participants’ educational backgrounds and household income level. This information is required of all participants and may need to be verified in order for students to qualify for participation. Additionally, this is the same information required if the student expects to receive any federal financial aid. EDUCATIONAL TALENT SEARCH ENSURES THAT ALL INFORMATION PROVIDED WILL BE HELD IN CONFIDENCE.
Both ParentsMotherFatherLegal guardianOther
YesNo
Name of parent(s)/Legal Guardian(s) with whom student lives*

First NameLast Name
Parent Guardian: Phone Number*
(999)999-9999
Parent/Guardian Email(s)*
example@example.com
Please indicate the highest educational level completed by birth or adoptive parents with who the student resides:
Elementary ScoolHigh School/GEDCollegeUnknown
YesNo
If yes, name of college*
Degree*
Elementary ScoolHigh School/GEDCollegeUnknown
YesNo
If yes, name of college*
Degree*
YesNo
PART III

For the next three questions, you will need the 2024 federal income tax form of theparent/guardian who claimed the student applicant.
*To document the 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 2024 Federal Income Tax Return.

Cancelof
Teacher Recommendation Name

First NameLast Name
Teacher Recommendation Email
example@example.com
Counselor Recommendation Name

First NameLast Name
Counselor Recommendation Email
example@example.com
Please indicate the 2022 taxable income which is the exact number that appears on Line 15. *
SingleMarried filing jointlyMarried filing separatelyHead of householdQualifying widow(er)
Total number of dependents listed*
My signature below indicates that, to the best of my knowledge, the information given on this application is true, complete and accurate. I hereby authorize Educational Talent Search to obtain copies of any of my child’s records (i.e. report cards, college enrollment status, etc.) from educational institutions my child presently attends or from educational institutions attended in the future.
Parent Signature*

Clear
Date*

MonthDayYear
mm-dd-yyyy
PART IV-Student Personal Statement
Please write a brief statement indicating why you want to participate in the Educational Talent Search program. You may also include what you expect to gain from your participation in the program.*
Activities/Clubs you presently participate in: In school (i.e. National Honor Society, Foreign Language Club, BPA, FFA, Educators Rising, HOSA, sports, etc) and out of school activities (i.e.Boy Scouts, Girl Scouts, 4-H, Church Youth Groups, community sports teams etc)*
Student Signature*

Clear
Date*

MonthDayYear
mm-dd-yyyy
The mission of the Educational Talent Search program is to partner with students, families, and the community to ensure each student acquires the education and skills necessary to achieve their educational, vocational, and personal goals to become globally competitive in the workforce.

*** If you require specialized accommodations based upon disability, please bring this to the attention of the Program Manager who will work with the appropriate personnel to address individual needs. **

This material is the sole property of Delaware Technical Community College. General use, duplication and reproduction are prohibited without written permission.

Educational Talent Search Application

Part 1: Student Information

PART II. Parent/Guardian Information

PART III

PART IV-Student Personal Statement