Wahupa Educational Enterprises, Inc.-EOC-Parent Form

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To establish eligibility for your child to receive free counseling services regarding career options, and college and financial aid opportunities, please provide the following information requested below:

Your Name*

First NameLast Name

Email*

example@example.com

Biological or adoptive fatherBiological or adoptive mother

Name of Your Child*

First NameLast Name

Some College, High School or belowBachelor’s Degree or beyondUnknown

What was your (and your spouse’s) taxable income last year (Jan.-Dec.)?*

Number in household (including yourself, spouse, and children)*

I understand that the information provided above is kept strictly confidential and is used to establish eligibility for free TRIO/EOC services. I certify that all my responses are correct to the best of my knowledge.

Parent signature:*

Date*

Date

COLLEGE AND CAREER COUNSELING SERVICES