Austin Community College-TS-Application Form

TALENT SEARCH APPLICATION
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Talent Search is a federally funded TRIO program through the U.S. Department of Education. We provide our students with academic support, career guidance, college enrollment, and financial aid assistance. Students also have the opportunity to participate in college & career exploration visits. The main goal of our grant is to encourage students to enroll in the higher education institute of their choice after graduation.

You can submit your application to the front office of your school, or scan and email to talentsearch@austincc.edu upon completion.

Feel free to contact us at 512-223-1464.
Name*

First NameM.I.Last Name
Mailing Address (include Apt #) (City, State, Zip Code)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date of Birth:

MonthDayYear
mm-dd-yyyy
Age:
Preferred Gender (select one):

MFnon-binary
School:
Student Cell #
(999)999-9999
Email address:*
example@example.com
Citizenship (select one):

U.S. CitizenNon-U.S. Citizen
Social Security #
999-99-9999
If non-U.S. Citizen, have you applied for U.S. Citizenship (select one):

YesNo
Ethnicity (you may select more than one):

African American/BlackNative HawaiianWhiteHispanic/LatinoAsianAmerican IndianOther
Education Information:
Name of School you’re currently attending:
Grade:
Student I.D.
Are you enrolled in another educational program at school?

YesNo
Name of Program?
(e.g. Gear Up, Upward Bound, Talent Search, etc.)
Family Information
Name (Mother/Guardian):

First NameLast Name
Cell/Phone #:
(999)999-9999
Work Phone #:
(999)999-9999
Mother’s/Guardian’s highest level of educational attainment:

High School Completion/GEDAssociate’s DegreeBachelor’s DegreeMaster’s or higherOther
Name (Father/Guardian):

First NameLast Name
Cell/Phone #:
(999)999-9999
Work Phone #:
(999)999-9999
Father's/Guardian’s highest level of educational attainment:

High School Completion/GEDAssociate’s DegreeBachelor’s DegreeMaster’s or higherOther
Family Size and Income Information

(To be completed by the parent/guardian)
Number of family members/dependents living in household (including yourself):
Do both parents live in home?

YesNo
Is your student receiving Free or Reduced Lunch?

YesNo
Is your family receiving public assistance?

YesNo
If yes, which type (eg. TANF, Social Security, Disability, other):
Household Annual Income Verification - Self-Report

NOTICE: Talent Search is required by federal mandate to obtain income information for the household in which the student resides to determine student eligibility. Federal mandate also requires preference be given to students who meet certain income criteria. Please know this information is kept confidential and only used for eligibility purposes.

Please note that Taxable Income is usually lower than Adjustable Gross Income which is located at the bottom of the first page of tax forms. Annual Taxable Income can be found on page 2 of most tax forms. Please call the Talent Search office at 512-1464 if you have any questions or need assistance locating this information.
Annual Taxable Income:
Please select if applicable:

I DID NOT file a Federal Income Tax Form because my gross income was insufficient to require filing.
If NO Federal Income Tax was filed for this year because the gross income was insufficient to require filing, please check alternative forms of income (check all that apply)

Child SupportWelfare/Social ServicesAid to Families with Dependent Children (AFDC)UnemploymentDisabilityVeterans BenefitsRetirementOther
Please review the following Media Release:

Talent Search requests permission to use my child’s picture/image, and/or accomplishments as a result of my child’s participation in the program. These images/pictures may be used on program brochures, flyers, or be published on the program’s website to activities and participation. If I grant permission, I release any claims against Austin Community College, the Talent Search Program, and/or its staff for any damages, awards, claims or liabilities which may arise from any unauthorized use or copyright violations of my child’s image, picture or work.
After reading the Media Release, do you give Talent Search permission to use your child’s picture/image?

YesNo
By signing below, you, the PARENT/GUARDIAN agree to the following:

Consent for Services:

I understand pre-college and educational outreach services including but not limited to academic advising, tutoring services, cultural enrichment activities, career and college exploration; will be provided as needed. Services are provided by Talent Search staff (counselors, mentors/tutors, teachers), and are designed to help students achieve their academic and personal goals. These services are provided free of charge and at the student’s will.

Release of Information:

I authorize Talent Search to access academic and personal information in the legitimate educational interest of my student including but not limited to: public assistance, free & reduced lunch documentation; standardized test scores (STAAR, SAT, ACT, TSI, GED); report cards; unofficial transcripts; official transcripts; attendance records; information about the status of post- secondary education admission/enrollment; financial aid documentation including FAFSA pin, SAR, and award letters in accordance with the Family Educational Rights and Privacy ACT (FERPA). I understand this information is essential in assisting me/my child in preparation for post-secondary education. I further understand all information received is for Talent Search use only and is held strictly confidential.

I understand that I am giving the Austin Community College Talen Search Program’s Director and Program Staff permission to access my students’ grade and attendance information directly from appropriate school personnel and to request other academic and behavioral information directly from appropriate school personnel and to request other academic and behavioral information directly from school staff. I intend to give permission for Talent Search to access and collect this information for the duration of my student’s participation in the program and throughout their high school and college career; however, if I choose to withdraw this permission, I can call the Program Director.
Parent Signature:

Clear
Date

MonthDayYear
mm-dd-yyyy
By selecting 'I Agree', I certify that the above information is correct to the best of my knowledge. I understand that this information is being provided as a matter of record; it will be kept strictly confidential. I authorize this program to obtain copies of my transcripts, test scores, financial aid awards, and other materials necessary for participation in the program. I will also grant permission for my photograph, photographic image, and/or video recorded image to be published in materials such as newsletters, annual reports, recruiting presentations, web pages, e-Profiles, etc., and release this program from any liabilities.

I Agree

TALENT SEARCH APPLICATION

Education Information:

Family Information

Family Size and Income Information