Gateway Community & Technical College-SSS-Application Form

TRIO Project ASPIRE

Gateway Community and Technical College

Program Application 2025-26
Legal Name:

First NameLast Name
Preferred Name:
Date of Birth:

MonthDayYear
mm-dd-yyyy
Gender:
Ethnicity:
Home Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
KCTCS/Gateway Student ID#:
KCTCS/Gateway Email Address:
example@example.com
Personal Email Address:
example@example.com
Cell phone:
(999)999-9999
Gateway TRIO Project ASPIRE may send SMS text messages to provide information and services related to the program. You can expect monthly messages about important deadlines, upcoming events, and appointment reminders. Do you agree to receive text messages from us?
Home Phone:
(999)999-9999
How did you hear about TRIO

Other
Education Information:
High School Graduate Year?
{year)
GED Year?
(year)
Degree Plan: Major
Degree Plan:
Graduation Plan:
Do you intend to transfer to a four-year institution
Are you Registered in the Gateway2NKU transfer program?
Are you participating in the River City Promise Program?
TRIO Eligibility Information:
Are you Pell Grant eligible?
Do either of your parents/guardians have a bachelor's degree?
Are you a U.S. Citizen?
If No, are you eligible for federal financial aid?
Permanent Resident?
Do you have a federally recognized disability?
Are you registered with Gateway's Office of Accessibility Services?
Signature

Clear
Date

MonthDayYear
mm-dd-yyyy
TRIO Project ASPIRE

Gateway Community and Technical College

Income Verification 2025-26
Based on your answers to the FAFSA Dependency Determination questions above are you:
Use information from your 2024 Federal Income Tax Return in this section:
How many people live in your household? (include yourself and children away at school)
What was the taxable income on your 2024 Federal Income Tax return? (As listed on your FAFSA) See line 15 on IRS tax form 1040.
By signing below, I certify that the information provided in this section is accurate and taken from my 2024 Federal Income Tax Return? I understand that failure to complete and sign this section will result in our inability to process this application for participation in TRIO Project ASPIRE.
Signature

Clear
Date

MonthDayYear
mm-dd-yyyy
(Independent status requires student signature only)
Parent Signature

Clear
Date

MonthDayYear
mm-dd-yyyy
TRIO Project ASPIRE

Gateway Community and Technical College

Individual Needs Assessment 2025-26
Student Name:

First NameLast Name
KCTCS/Gateway Student ID#:
Please take the time to identify ways in which the TRIO-Project ASPIRE project can support you in your academic career here at Gateway Community & Technical College. Check all that apply .
Academics:
Major/Career:
Personal:
Signature:

Clear
Date:

MonthDayYear
mm-dd-yyyy
TRIO Project ASPIRE

Gateway Community and Technical College

Program Participation Agreement 2025-2026
TRIO Project ASPIRE Participation Contract

If accepted into TRIO Project ASPIRE services, I will be eligible for the following benefits:
- Dedicated TRIO advisor who serves as my Academic, Career, and Resources consultant
- Individualized Success Plan to guide my college experience
- Financial Aid counseling
- Degree Audits
- Transfer counseling
- Monthly Success Workshops
- Tutoring resources
- Dedicated computer lab with free printing
If accepted into TRIO Project ASPIRE services, I will agree to the following:
- Complete an Individual Success Plan (ISP) within the first 4 (four) weeks of the fall term
- Meet with my TRIO Advisor at least 2 times per semester
- Committed to working with my TRIO Advisor in developing plans to support my academic success.
  - First year Plan with Goal Setting
  - Majors plan
  - Career plan
  - Graduation plan
  - Transfer plan
- Complete Financial Aid Audit each fall
- Submit my FAFSA by Oct 1 for priority consideration for all state and federal aid
- Submit the KCTCS/Gateway scholarship application each March
- Review my midterm grades each semester and discuss my progress with my TRIO advisor
- Read email communications from TRIO to stay up to date of program activities, resources and deadlines
- Complete any recommended/required online modules
- Be honest and conscientious with my TRIO Advisor and use the TRIO services to assist me in being a successful college student
To fulfill these responsibilities, I will:
- Notify program staff if I cannot attend a scheduled appointment, event or workshop . I will make this contact at least 24 hours before the scheduled time.
- Communicate any concerns with classes or financial aid as soon as possible for the greatest chance for success
- Complete classroom assignments on time and adhere to the institutions code of conduct
- and honesty around plagiarism and the use of Al in classroom assignments
Signature

Clear
Date:

MonthDayYear
mm-dd-yyyy
TRIO Project ASPIRE

Gateway Community and Technical College Program

Consent to Release 2025-2026
I understand that TRIO Project ASPIRE needs to access to my financial, personal, academic, and disability related information in order to provide the best possible support for me at Gateway Community and Technical College. Therefore, I agree to release such information to the TRIO staff members as long as I am considered an active TRIO participant or a Gateway student. I further understand that all released information/material will remain confidential. I also agree to allow sharing of information with Community partners like the Scholar House.
I agree to allow my name and/or picture to be printed in any TRIO Project ASPIRE newsletters, website, publication, or display in recognition of academic success, involvement, leadership or graduation
Signature :

Clear
Date:

MonthDayYear
mm-dd-yyyy

Education Information:

Graduation Plan:

TRIO Eligibility Information: