University of Northern Iowa-Educational Talent Search Cedar Rapids

Educational Talent Search Cedar Rapids

The University of Northern Iowa
Educational Talent Search - Cedar Rapids (ETSCR) is a federally funded TRIO Program designed to assist middle and high school students with completing high school and transitioning to a postsecondary institution or vocational program of their choice.

To be eligible for participation, students must be citizens or permanent residents of the United States. Specifically, students from select Cedar Rapids public middle or high schools - Franklin, McKinley STEAM, Roosevelt, Wilson, Jefferson, and Washington - are encouraged to apply. Upon submission, all applications undergo evaluation, and students will receive notification regarding their application status.

Applicants are strongly encouraged to apply online. However, paper applications are available upon request from either their school counselor or an ETSCR educational counselor. A complete application includes a school records release form, a social media form, and all required signatures. Incomplete applications will delay the process.

Services Offered Through the Educational Talent Search Program:
• Study Skills Workshops
• High School Course Selection
• Completion of Admissions Applications and waiver of application fees
• ACT/SAT Prep
• ACT/SAT fee waivers
• Assistance with Applying for Financial Aid, College Tours, and Cultural Field Trips
• Career Planning
• Career Exploration/Job Shadowing
• GED/HiSet Information
• Tutoring
• Secondary/Postsecondary Reentry Scholarship Searches
• Financial and Economic Literacy

Statement of Confidentiality
The personal information you submit to the UNI Educational Talent Search Program is necessary to determine if the student is eligible to participate in the program. This information is protected by the Privacy Act and no one may see this information unless they work with or for the University of Northern Iowa Educational Talent Search Program.

ETSCR is required to verify that our participants meet federal criteria based on educational background and household income. ETSCR ensures that all information provided will remain confidential.

Parent/Guardian 1
Name*

First NameLast Name
Relationship*
Phone # 1 *
(999)999-9999
Phone # 2
(999)999-9999
Email Address*
example@example.com
Parent/Guardian 2
Name

First NameLast Name
Relationship
Phone # 1
(999)999-9999
Phone # 2
(999)999-9999
Email Address
example@example.com
YesNo
(if yes, please list the parent(s) and name(s) of the college/university)
What is the primary language in your home? *
Total number of people living in the household: *

Do you have any other 6th-12th grade students?

Rows	Student Name	School Currently Attending	Grade
1
2
3

under $23,940$23,941 - $32,460$32,461 - $40,980$40,981 - $49,500$49,501 - $58,020$58,021 - $66,540$66,541 - $75,060$75,061 - $83,580$83,581 & Over
If you did not file an income tax return last year, please write in your taxable income:
I verify that the information provided on this application is true, complete, and accurate to the best of my knowledge.
Parent/Guardian Signature*

Clear
Date*

MonthDayYear
Date

Student Name

First NameLast Name
To the officials of Cedar Rapids Community Schools, I hereby grant permission for the University of Northern Iowa Educational Talent Search - Cedar Rapids program (ETSCR) to have access to the records of the student, including the cumulative, quarterly and semester grades, test scores, transcripts, and class schedules, during their 6th -12th grade enrollment in the ETSCR program.

I understand my child’s records will be kept in a confidential file and used for the following purposes:

• To assist ETSCR personnel as they support my child’s preparation for success in accessing and completing postsecondary education.
• To provide data to the U.S. Department of Education and to the University of Northern Iowa for the sole purpose of assessing the effectiveness of ETSCR in providing services to its participants.
• To contact the student and/or family members as needed for purposes related to enrollment in the program.

I understand I may revoke this release at any time by submitting to the University of Northern Iowa ETSCR a dated, signed statement denying the release of secondary school records.

This records release form will be valid (6th-12th grade) or until the student has exited out of the program.
Student’s School*
Grade*
Student’s School ID#*
Parent/Guardian Name*
Current Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone #*
(999)999-9999
Parent/Guardian Signature *

Clear
Date*

MonthDayYear
Date

Student Name

First NameLast Name
I authorize the University of Northern Iowa (UNI) to videotape, photograph, record, edit, copy, display, perform publicly, distribute, use and re-use my (or my child’s) image, voice, and likeness in all current and future UNI productions, projects, future media and promotional materials, in any manner, including print, tape, broadcast, digital media, and/or yet to be developed technology. I understand that my (or my child’s) image, voice, and likeness may be distributed in the United States and elsewhere for an unlimited time.

I understand that I will not receive any compensation as a result of any such videotaping, photography, recording, editing, copying, display, public performance, distribution, use or re-use of my (or my child’s) appearance, including my (or my child’s) image, voice or likeness. I understand and agree that UNI owns the copyright and all other media distribution rights relating to the appearance. I waive any rights of privacy and/or publicity that I may have with regard to the appearance and any re-use or further use of the appearance. I release any and all claims or causes of actions of any nature that I may have, now or in the future, against the University of Northern Iowa, the Board of Regents-State of Iowa, the State of Iowa, and their employees and agents in connection with the appearance. The laws of the State of Iowa will govern this release, without regard to the conflict of law provisions. I represent that I am the parent or legal guardian of the student, that I have read and fully understand the contents of this release, and that I consent to this release on behalf of the student.
Parent/Guardian Name*
Current Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone #*
(999)999-9999
Parent/Guardian Signature *

Clear
Date*

MonthDayYear
Date
Educational Talent Search - Cedar Rapids

800 Sycamore St. / Waterloo, IA 50703-4730 / (319) 273-4772