• PROJECT ACHIEVE APPLICATION

    • Personal Information 
    • Today’s Date:*
       - -
      2 digit month, 2 digit day, 4 digit year
    • Date of Birth:*
       - -
      2 digit month, 2 digit day, 4 digit year
    • Sex Assigned at Birth: (required for legal reporting purposes)*
    • Ethnic Background: (check all the apply)*
    • Are you a U.S. citizen?*
    • If “No”, are you eligible for Federal Financial Aid as a noncitizen?
    • Education Information 
    • Class Standing:*
    • Have you previously received a bachelor’s degree?*
    • Have you taken a Math Placement Exam?*
    • If “No”, when will you take one?
       - -
      2 digit month, 2 digit day, 4 digit year
    • Have you taken an English Placement Exam?*
    • If “No”, when will you take one?
       - -
      2 digit month, 2 digit day, 4 digit year

    • What is your intended major and/or minor at the University of Nebraska at Omaha? (if undecided, write in “Exploratory Studies”)

    • Following graduation, do you plan to apply to graduate or professional school?*
    • Program Qualifying Information 

    • Family Income (Income documentation from independent students or from the parents/guardians of dependent students will be needed at the time of your scheduled appointment with Project Achieve Staff)

    • Are you currently receiving financial aid?*
    • If “No”, do you have plans to complete the FASFA? (Free Application of Federal Student Aid)

    • What is the highest level of education for your parent(s) or guardian(s)?

    • If you have a disability, please select all that apply below: (This question is optional)
    • Support Services Needed: (Check All that Apply)*
    • Are you currently employed?*
    • If “Yes”, where?
    • How many hours a week?
    • Have you been previously enrolled in Project Achieve?*
    • If “Yes”, When?
       - -
      2 digit month, 2 digit day, 4 digit year
    • To?
       - -
      2 digit month, 2 digit day, 4 digit year
    • Written Questions 
    • Acknowledgements and Signature 
    • Date*
       - -
      2 digit month, 2 digit day, 4 digit year
  • Should be Empty: