277909-University Of Houston-Downtown-HISD-TS-Application Form-Ian

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General Information
**All application/parent information is secure**

Thank you for your interest in Educational Talent Search!

Educational Talent Search (ETS) is a program designed to help students prepare for college. All program services are FREE. We provide academic advising, college tours, cultural activities, assistance with scholarship applications, and more! Students interested must attend one of the following schools:
- Clifton Middle School
- Marshall Middle School
- Northside Senior High School
- Scarborough Senior High School
Because the Department of Education federally funds the ETS program, there are specific documents we are required to obtain in order to determine eligibility for the program. To complete your application the following documents are needed:
1. Completed ETS Application (with Social Security number and taxable income included)
2. Most recent Transcript (if in high school) and/or Report Card/Progress Report
3. If applicable, a copy of an award letter if you are receiving federal assistance such as: TANF, Social Security, Disability, etc.
Although not required, for expedited processing of your application please include:
o A copy of your most recent tax form (1040)
o A copy of the student’s Social Security card and/or Permanent Resident Card

All information is kept confidential and is used only to determine eligibility for the Educational Talent Search program.

Sincerely,

TRIO Educational Talent Search Staff University of Houston Downtown

Website: www.uhd.edu/talentsearch | Email: TalentSearch@uhd.edu | Phone: 713.221.8992

Student Citizenship
(You must be a U.S. Citizen, permanent resident, or an eligible non-citizen to be a member of ETS. Check ONLY one box)
Select One*

U.S. CitizenPermanent Resident (list number below)Eligible Non-Citizen (list number below)
Permanent Resident #
Eligible Non-Citizen #
Social Security #
999-99-9999
*For Expedited processing of your application, please provide a copy of student’s Social Security Card and/or Permanent Resident Card
Social Security Card

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Permanent Resident Card

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Income Eligibility
What is total number of those currently living in your household?*
Does your child qualify for the Free/Reduced Lunch Program?*

YesNo
Please check ONLY one box*

I filed taxes for the year ____________. My total taxable income was ______________. Please note that the taxable income is the amount after deductions (NOT GROSS INCOME).I did NOT file taxes for the previous tax year. My total income was _______________.
I filed taxes for the year *
YYYY
My total taxable income was (this information can be found on page 2, line 10 of the 1040)*
$_________
My total income was *
$_________
If available, please submit a copy of your most recent signed income tax returns (1040). This information will be kept confidential and used only to determine eligibility for the Educational Talent Search program.

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Signatures
By signing my name on the signature below, I certify that the information in this application is complete and accurate to the best of my knowledge. If accepted into the UHD ETS program, I will strive to continually improve my academic performance and maintain an active ETS participant.
Student Signature*

Clear
Date*

MonthDayYear
mm-dd-yyyy
By signing my name on the signature line below, I certify that the information in this application is complete and accurate to the best of my knowledge. I understand that this information will be used to verify eligibility and to provide data in compliance with federal regulations. I also give my consent to the University of Houston Downtown Educational Talent Search program to obtain transcripts and any educational records that pertain to my child’s academic progress.
Parent/Guardian Signature*

Clear
Date*

MonthDayYear
mm-dd-yyyy

Authorization
Student Name*

First NameLast Name
Student Signature*

Clear
CONSENT OF PARENT/LEGAL GUARDIAN REQUIRED IF ABOVE INDIVIDUAL IS A MINOR.

I am the parent and/or guardian of the above minor and hereby consent and agree to the foregoing terms and provisions on his or her behalf.
Parent/Legal Guardian Name*

First NameLast Name
Signature*

Clear