Palomar College-EOC-2024 Application Form
Language
  • English (US)
  • Español
  • PARTICIPANT APPLICATION

  • Date of Birth
     - -
  • Are you a U.S. Citizen?
  • Are you a Permanent Resident?
  • Do you have a GED/High School Diploma?
  • Do you have a College degree?
  • Are you interested in a post-secondary education?
  • Did either of your parents earn a 4-year degree before you turned 18?
    • Student, please answer the following questions about yourself 
    • What is your gender?
    • What is your Marital Status?
    • What race/s do you identify with? Please check all the boxes that best describe you
    • U.S. Military / Dependent of Military Please check all the boxes that apply to you
    • Are you fluent in English?
    • Are you a registered disabled student?
    • Verification of Income 
    • Taxable annual household income (less than or equal to)
    • Household size - include yourself
    • Please indicate all your source(s) of incomeCheck all that apply
    • Educational Information 
    • What do you need assistance with?
    • Are you currently in High School or equivalent program (adult/continuation school)?
    • Have you ever attended College?
    • Are you PRESENTLY a participant of any of the following programs?
    • Release of Information 
    • Clear
    • Date
       - -
    • Information Release - Information provided to TRiO NCEOC is confidential and will not be released without the student’s permission. By signing this form, you authorize TRiO NCEOC to receive and release information to/from all applicable educational and career institutions to assist me in my education planning, verify enrollment and secure financial aid opportunities for program participants. In addition, my information may be released to the Department of Education to demonstrate program effectiveness when requesting renewed funding. Photo/Media Release - Much of our publication and marketing success is from the use of photos and videos taken of TRiO NCEOC students during program events. By signing this form, you give the irrevocable right to use your name, photo or video in all forms and media and in all manners, including composite or distorted representations, for advertising, trade or nay other lawful purposes, you waive any right to inspect or approve the finished version(s), including written copy that may be created in connection therewith. I verify that I am at least * 18 years of age, I have read this release and am familiar with the content

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