Student Support Services Application Packet

The levels listed above are based on the size of my family unit. I understand that my family unit includes myself, my spouse (if applicable), and my dependents. If I (a student) am a ward of the court, my family unit includes only myself.

I also understand that this is a federally funded program and that this information is subject to review by Federal authorities if the TRIO program to which I have applied is audited, and I will be held responsible for the certification made by my signature. I affirm that this information is true and accurate to the best of my knowledge.

In accordance with the Family Education Rights and Privacy Act of 1974, I hereby authorize the release of my records in reference to academic transcripts, degree plans, personal assessment test scores, and other pertinent information related to my educational endeavors to the Coker University TRIO Student Support Services Program and Staff.

I hereby authorize, TRIO Student Support Services Program and Staff to transmit and/or request any information about me for the purpose of assistance in verifying eligibility, determine appropriate services, and to track my academic progress from Admissions, Academic Affairs/Faculty, Student Records, and the Office of Financial Aid. Additionally, (if applicable), I authorize Coker University Student Disability Services to verify that I have provided documentation that registers me as a student with a disability.

I understand the above is necessary to establish my eligibility to receive services from the program. I understand the Department of Education requires the submission of TRIO Student Support Services participant’s demographic, participation, and academic data. I also understand that completion of this application does not guarantee acceptance into the TRIO Student Support Services program.

I understand that I must cooperate and be an active participant by regularly attending TRIO Student Support Services sponsored activities and appointments required by the TRIO Student Support Services office.

Furthermore, I understand that failure to perform according to the program’s requirement will jeopardize my opportunities to received TRIO Student Support Services. These services include the following: (Personal and academic counseling and advising; Tutorial Assistance; Mentoring; Career Counseling and Assessment;
Workshops on study skills, note taking skills, etc.; Assistance in securing admission to a graduate university; and Cultural Enrichment and Educational Events).

My signature certifies that the information provided on this application is true and correct to the best of my knowledge. Also, I certify that all the information provided in the household income/financial aid section of this form is correct and true to the best of my knowledge. I also agree, (if requested) to provide documentation, including a copy of my (and/or parental) U.S. income tax return, to verify the accuracy of the information given.