University Of Akron-TS-2024 Application Form

Educational Talent Search Information Sheet
OBJECTIVE
Educational Talent Search (ETS) is a federally funded TRiO program which provides services to assist in the successful enrollment or re-enrollment of students into postsecondary education. The Educational Talent Search Program is sponsored by The U.S. Department of Education and The University of Akron. The total dollar amount of Federal Funds awarded for the 5-year grant period (2021-2026) is approximately $2,332,800. Our mission is to provide academic, social, and cultural experiences for students from grades 6th-12th. We also provide academic services for adults who have not completed high school or received their GED as well as those who stopped out of college. The ETS program enhances academic instruction through an intensive
summer program and academic activities throughout the year.

SERVICES
ETS provides the following services at no cost to the student:
• Financial Aid Information
• Monthly Workshops
• Tutoring
• Career Assessment & Exploration
• College Campus Visits
• ACT Preparation Classes
• ACT Waivers
• College Application Waivers
• Assistance in Completing College Applications
• Assistance with Financial Aid Applications & Scholarships

OPPORTUNITIES
ETS provides the following opportunities for students at no cost to the student:
• 3 Week Summer Enrichment Program (1 Week for Seniors)
* Academic Preparation Courses
* Cultural Field Trips
• Special Events During the Academic Year
• Ceremonies

STUDENT EXPECTATIONS
In order to participate in the ETS program, students are expected to:
• Maintain a 2.3 or above GPA
• Attend In-School Workshops
• Attend Tutoring if their GPA falls below a 2.3
• Be Respectful & Have Good Character

Eligibility
Educational Talent Search provides services to a diverse population of students. 2/3 of the ETS participants are low income and potential first generation college students. The remaining 1/3 of the participants are either low income, potential first generation, or neither. All students are welcome to apply if they have a 2.3 grade point average or above and are enrolled in our service area.

To Apply
Contact your School Counselor for an Application
• Contact the ETS office for an application
• Apply online at: www.uakron.edu/aap/ets/

Student U.S. Citizenship
Are you an U.S. Citizen?*

Yes, I am an U.S. CitizenNo, but I am an eligible non-citizen
If you are NOT an U.S. Citizen, we will need verification of permanent residency from the Immigration Department:
Permanent Resident Number:*
Date Issued:

MonthDayYear
Date
Are you enrolled in any of the programs below? If so please check the box.

Strive Toward Excellence Program (STEP)Upward Bound Classic (UBC)Upward Bound Math/ Science (UBM/S)

Parent Information
Only provide information for the parent/guardian with whom you live
With whom does the applicant reside?*

MotherFatherBothGuardian
Guardian Relation

Student Medical History
Please complete this form accurately and list all information
Please provide all facts concerning the student’s medical history. This information is used to better accommodate our participants.

Does the student currently have or has had any of the following conditions? If yes, please mark the box beside the condition and explain. EX: Cancer: Throat Cancer

	Condition	Date of Diagnosis	Currently Treated? Yes	Currently Treated? No
Cancer:
Heart Disorder:
Seizure Disorder:
Brain Disorder/ Injuries:
Stomach Disorder:
Suicidal Attempts/ Desire:
Arthritis:
Emotional or Mood Disorder:
Kidney Disorder:
Genetic Disorder:
Menstrual Problems:
Joint Disorder/ Injuries:
Back Problems:
Eye Problems:
Ear Problems:
Nose or Throat Problems:
Respiratory Problems:
Disabilities:
Other:

Please provide a brief description of any Treatment Plans. You may use and attach an additional sheet of paper if necessary.

Please list all allergies, threatening and non-threatening.

	Allergy	Reaction to Allergy	Treatment
1
2
3
4
5

Please list counseling history. Ex. Depression, Family Counseling, ADHD

	Type of Counseling	Agency	Dates	Currently Attending Yes	Currently Attending No
1
2
3
4

Additional Information:

School Record Release
Student Name*

First NameMiddle NameLast Name
Date of Birth(Month/ Day/ Year):*

MonthDayYear
Date
Gender Assigned at Birth:*

FemaleMale
Name of School Attending *
Grade *
Counselor Name*

First NameLast Name
I hereby grant permission for the officials at my child’s school to release copies of his/her permanent record, test scores, and grades to the Educational Talent Search Program at The University of Akron. Permission for the release of my child’s school records will remain in effect until he/she is no longer a program participant or until he/she has graduated from high school.

Confidentiality of school records is protected by state and federal law. Any person/facility receiving authorized information may not make further disclosure without the written consent of the person to whom it pertains.

I understand that I can revoke this authorization at any time by providing written notice to the person/facility who I designated to release the information. I understand that any information released prior to revocation cannot be retrieved and neither person/facility receiving the information will be held responsible for such.

I hereby release Educational Talent Search, The University of Akron, and its employees and agents from all legal responsibilities or liabilities that may arise from this act.
Legal Guardian Signature *

Clear
Print Name *

First NameLast Name
Date*

MonthDayYear
Date

Summit Education Initiative Release of Student Records
The University of Akron Educational Talent Search (ETS) is partnering with the Akron Public Schools and Summit Education Initiative to promote the success and academic achievement of students in Summit County. Summit Education Initiative (SEI) is
a nonprofit organization located in Akron, Ohio, dedicated to increasing educational attainment in Summit County, Ohio. In this work, SEI provides secure data access between Akron Public Schools and The University of Akron Educational Talent Search (ETS).

The Family Education Rights and Privacy Act (FERPA) protects students and parents by prohibiting most third parties from accessing student records, information, or data without clear permission from a parent or guardian if the student is under 18.

This form requests your consent to allow The University of Akron Educational Talent Search (ETS) to share the name, grade level, date of birth, student ID number and school of your child with SEI. Additionally, you are consenting to allow SEI to provide The University of Akron Educational Talent Search (ETS) access to your child’s Akron Public Schools data, including test scores, grades, attendance records, and results of student surveys. Your consent allows data to be shared in two directions: from The University of Akron Educational Talent Search (ETS) to Akron Public Schools; and from Akron Public Schools to The University of Akron Educational Talent Search (ETS). SEI is acting on behalf of both parties to match the information provided by The University of Akron Educational Talent Search (ETS) with your child’s school information, and to conduct research to determine the effectiveness of programs on student success and achievement.

Accessing or sharing records, information, or data will be done to promote and support your student’s academic success and achievement, and to evaluate services being offered. No records, information, or data will be used for any other purpose, and will not be shared with any party other than those listed in this release.

Parent/ Guardian Consent

I give consent for Summit Education Initiative to provide secure sharing of my child’s personally-identifiable information between The University of Akron Educational Talent Search (ETS) and Akron Public Schools. I understand the following information will be shared:
• Student Name, Grade Level, Date of Birth, and Student Id Number
• School District Name and School Building Name
• Course Grades and Grade Point Average
• National and State Test Results
• Attendance Records (Classroom and School Absence totals, both Excused and Unexcused)
• Results of Surveys Administered at the Building and/or at the District Level

I understand that my child’s information will only be shared between Summit Education Initiative, The University of Akron Educational Talent Search (ETS) and the Akron Public Schools, and that this consent may be terminated at any time by my written request as the parent/guardian listed below. It is also my understanding that this consent will last until my child is 18 years old: unless it is revoked by me in writing, my child is no longer affiliated with The University of Akron Educational Talent Search (ETS), or registered as a student in Akron Public Schools. As a legal guardian, I have the right to revoke consent at any time. I also have the right to obtain copies of any information about my child that is shared because of this
form.
Legal Guardian Name (Print)

First NameLast Name
Legal Guardian Signature

Clear
Date of Consent

MonthDayYear
Date
Child’s Name

First NameLast Name
Date of Birth (MM/DD/YYYY)

MonthDayYear
Date
Child’s School District
School Building
Student ID Number
Upload report card*

Cancelof

Educational Talent Search Information Sheet