• Application for SSS Program Services

  • PERSONAL DATA

  •  - -
  • CITIZENSHIP ELIGIBILITY (please check one)

  • Financial Information

  • Browse Files
    Drag and drop files here
    Choose a file
    Cancelof
  • For Independent Students:

  • For Dependent Students:

  • CAREER/ACADEMIC PLAN

  • VETERAN STATUS

  • Browse Files
    Drag and drop files here
    Choose a file
    Cancelof
  • STUDENT STATEMENT 

    (please read, sign and date)
  • I authorize TRiO SSS staff to gather information (standardized test scores, FAFSA application, GPA, transcripts, social security #, etc.) concerning my academic progress and financial status prior to my participation in TRiO SSS. I understand this information is used to assist in the determination of my eligibility for the program and it will be kept strictly confidential. I am aware that personal information provided to TRiO will be protected under the Family Education Rights & Privacy Act (FERPA) of 1974. I certify that the information provided on the application is true and complete to the best of my knowledge.

    I authorize TRiO SSS staff to send emails, texts, and phone calls pertaining to the SSS program and services.

  • Clear
  •  - -
  • Eligibility Assessment Information:

  • Browse Files
    Drag and drop files here
    Choose a file
    Cancelof
  • TRIO SSS Needs Assessment Information:

  • Acknowledgement and Consent

  • APPLICATION REVIEW REQUIREMENTS - Please read and sign the following statement:

    I am aware my TRIO Student Support Services Program Application will not be reviewed until all documentation, including IRS 1040 Forms/ Statement of Non-Filing Forms, has been received by the TRIO SSS Office. Missing documentation or incomplete information will result in the application being eliminated from the application process and, therefore, deemed ineligible for review.

     

    FERPA RELEASE - Please read and sign the following statement:

    In accordance with the Family Education Rights and Privacy Act of 1974, I hereby acknowledge and authorize the release and/or exchange of my records in reference to academic information (enrollments status, academic transcript, grade point averages, registration status, class schedule, etc.), financial aid information (financial aid application data, financial aid eligibility, financial aid awards, financial aid disbursements, financial aid academic progress status, etc.), loan information (University-maintained loan disbursements, billing, and repayment history balances, collection activity, etc.), student account information (billing statements, charges, credits, payments, past due amounts, collection activity, etc.), and any other pertinent information with the Eastern New Mexico University TRIO Student Support Services Program and Staff. I understand the U.S. Department of Education requires the submission of TRIO SSS Participant demographic, participation, and academic data. By signing below, I acknowledge and authorize the release of any and all of my educational and TRIO SSS programmatic information to third-party agencies, including but not limited to the U.S. Department of Education, TRIO SSS database entities, and National Student Clearinghouse.

     

    APPLICATION CERTIFICATION - Please read and sign the following statement:

    I certify that the information provided on this application is accurate and complete to the best of my knowledge.

  • Clear
  •  - -
    • Submit 
    • Should be Empty: