Texarkana College-EOC-Intake Form

  • Educational Opportunity Center at Texarkana College

    New Participant Intake Form

  • The Educational Opportunity Center at Texarkana College is a federally funded TRIO program and all services are provided to program participants FREE OF CHARGE. All individuals who meet the eligibility requirements of this program are provided information regarding financial and academic assistance necessary for them to enter the college of their choice. This is an outreach program of the U.S. Department of Education and Texarkana College.

    If you have earned a bachelor’s degree do NOT complete this form!

  • Would you like to receive text messaging with this phone number?*
  • Date of Birth:*
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  • Gender:
  • Citizenship:*
  • Ethnicity/Race: Are you Hispanic or Latino?
  • Race (Select all that apply):

  • Emergency Contact Information

  • Military Connected

  • What is your military connection status?*

  • Family Educational Background Information

  • Does either of your parents have a 4-year (bachelor’s) college degree?*

  • Participant Educational Background

  • What is your current level of education?*

  • Federal Program Participation

  • What is your immediate educational goal?*
  • Rows
  • Rows
  • Have you participated in any of the following program since September 1st? (Check all that apply)*

  • College Admissions and Financial Aid

  • Have you completed a college admissions application for the school you plan to attend?*
  • Have you completed a financial aid application (FAFSA) for the school you plan to attend?*

  • EOC Services Needed

  • What services can EOC assist you with?*

  • Dependency Status

  • If you cannot check any of the following boxes, you are considered a dependent student. Dependent students must provide parent financial information. *(please select all that apply to you)*

  • Household Size

  • What is your current marital status?*
  • Including yourself, how many people are supported by your income?*
  • Are there children under the age of 18 in your household?*

  • Financial Information

  • Did you or will you file a 2025 Tax Return?*

  • Authorization

  • I declare that the information on this form is true to the best of my knowledge. The Educational Opportunity Center at Texarkana College is authorized to access information deemed necessary to assist me in achieving my educational goals or in meeting the reporting requirements of the U.S. Department of Education, to record pertinent facts regarding my eligibility in the Program, services rendered, and placement. A copy of this statement shall serve as such authorization.

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  • Date*
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    • Submit 
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