University Of Nebraska-Lincoln-SSS-2024 Application Form

University of Nebraska-Lincoln TRIO SSS Application and Eligibility
Student Support Services (SSS) offers free academic support services to promote academic success. Our goal is to retain and graduate students who are first generation, low‐income and/or have a disability. SSS is a grant funded program through the U.S. Department of Education.

Eligibility is based on federally defined criteria where at least one of the following must be met:
- A first generation college student (neither parent has a Bachelor's degree)
- Low- income (verified by the Office of Scholarships & Financial Aid) and/or
- Have a documented learning or physical disability (verified by the Office of Services for Students with Disabilities)
Additional required criteria for eligibility:
- Be either a US citizen or permanent resident
- Pursing first bachelor’s degree
WHEN SHOULD I APPLY?

Immediately! Applications are accepted throughout the year, but the program size is limited. Your responses are necessary to determine program eligibility and will be kept confidential. If you have questions or need assistance with the application, please contact our office at (402) 472-2027.

How can SSS help?

Advising:
- General Academic Advising
- Course Selection Feedback
- Input on Major & Career Selection
- Career Counseling
- Preparation for Graduate/Professional School
Financial Assistance:
- FAFSA
- Scholarship Information
- Grant-Aid
- Financial Literacy Workshops
Academic:
- Workshops and Classes
  - Study Skills
  - Time Management
Personal Information
NU ID #*
Name*

First NameLast Name
Permanent Address *

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Cell Phone Number*
(999)999-9999
Personal Email*
example@example.com
UNL Email Address (Please provide if available)
example@example.com
Date of Birth*

MonthDayYear
mm-dd-yyyy
Gender*

MaleFemaleNon-binaryPrefer not to sayOther
Ethnicity*

American Indian or Alaska NativeAsianBlack or African AmericanHispanicNative Hawaiian or Other Pacific IslanderWhite
Eligibility Verification
What is your citizenship status?*

U.S. CitizenPermanent ResidentNeither
Does you parent/legal guardian have a bachelor's degree?*

YesNo
Are you a foster care youth (in foster care or aging our of the foster care system)?*

YesNo
Marital Status*

SingleMarried
Are you a parent or legal guardian of a child under the age of 18?*

YesNo
Dependency Status: Choose One*

Independent (report only your own income)Dependent (report your parent/guardian and your income)
State of Residence *
List the year on you or your guardian's most recent Tax Return *
Taxable Income*
Enter the Taxable Income for the prior tax year for either yourself (ifyou answered Independent above) or your parent/guardian (if you answeredDependent above)
Family Size*
Have you completed this year's FAFSA?*

YesNo
Based on your most recent FAFSA, were you eligible for the Federal Pell Grant?*

YesNo
Do you have a documented disability that has been reported to the Office of Services for Students with Disabilities?*

YesNo
Educational History
Have you participated in a TRIO program in the past? (Educational Talent Search or Upward Bound / Math Science, TRIO SSS at a different institution)*

YesNo
What year will/did you earn your High School Diploma or GED?*
Ex: Spring 2023
What was/will be, the date of your first class at the University of Nebraska- Lincoln?*

MonthDayYear
mm-dd-yyyy
Current Class Standing*

1st year, never attended1st year, attended before2nd year/ Sophomore3rd year/Junior4th year/Senior5th year/Other Undergraduate
Anticipated Graduation Term*
Ex: Spring 2023
Current GPA*
Composite ACT Score (If you did not take the ACT, fill in N/A.)*
Are you currently or have you ever been on Academic Probation? (In college)*

YesNo
Services and Resources
Which academic need(s) are you seeking support? (check all that apply)*

GPA Improvement 2.5 or aboveGPA Improvement 2.5 or belowTutoring Support in Math/ScienceTutoring Support in English/WritingStudy HabitsNot Interested in Academic Services
I would like SSS to help me with (check all that apply)*

Career Exploration and CounselingLeadership DevelopmentScholarship and Financial Aid AssistancePersonal CounselingUndergraduate ResearchFinancial LiteracyGraduate School PreparationOrganization & PlanningNot Interested in Additional Services
Check any SSS courses you are interested in taking? (SSS courses are designed to be smaller 20-25 students per class)*

ENGL 150 (Writing and Inquiry)ENGL 151 (Writing and Argument)BIOS 101 (General Biology)LIFE 120 (Fundamentals of Biology I)MATH 104 (Applied Calculus)MATH 106 (Calculus I)First Year SeminarNot Interested in Any Courses
Are you an individual who lacks a fixed, regular, & adequate nighttime residence (e.g. homeless or under-housed)?*

YesNo
Are you an individual who experiences uncertainty or difficulty in accessing sufficient, safe, and nutritious food to meet your dietary needs?*

YesNo
Please upload a picture of you. (For record keeping purposes only)*

Cancelof
Affidavit of Truth Statement
I hereby certify that the information provided is true to the best of my knowledge. I understand any false information given will result in the loss of the opportunity to participate.

I hereby authorize the release of my records in reference to academic transcripts, degree plans, personal assessment scores, financial aid, and any other pertinent information related to my academic endeavors to the Student Support Services staff of the University of Nebraska-Lincoln.
I consent to the Office of Scholarships and Financial Aid (OSFA) and or the Office of Services for Students with Disabilities (SSD) sharing information with TRIO Programs regarding whether I meet TRIO eligibility*

I consentI do not consent
Student Signature*

Clear
Date*

MonthDayYear
mm-dd-yyyy

University of Nebraska-Lincoln TRIO SSS Application and Eligibility

Personal Information

Eligibility Verification

Educational History

Services and Resources

Affidavit of Truth Statement