University Of Nebraska-Omaha-SSS-2025 Application Form

PROJECT ACHIEVE APPLICATION
- Today’s Date: *
  
  MonthDayYear
  mm-dd-yyyy
- Date of Birth:*
  
  MonthDayYear
  mm-dd-yyyy
- NUID: *
- Legal Name:*
  
  First NameLast Name
- Sex: (required for legal reporting purposes)*
  
  MaleFemale
- Current Address:*
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip Code
- Preferred Phone:*
  (999)999-9999
- Preferred Email: *
  example@example.com
- UNO Email:*
  example@example.com
- Are you a U.S. citizen?*
  
  YesNo
- If “No”, Are you a Permanent Resident?*
  
  YesNo
- Did you complete the Free Application for Federal Student Aid (FAFSA)?*
  
  YesNo
- If "No", do you plan to complete the FAFSA?*
  
  YesNo
- If you are receiving Federal Financial Aid, what type of assistance are you receiving?*
  
  Federal Pell GrantFederal Student LoansFederal Work StudyOther Grant Types (Federal Supplemental Educational Opportunity Grants (FSEOG) or Teacher Education Assistance for College and Higher Education (TEACH))Not receiving Federal Aid
- Have you previously received a bachelor’s degree?*
  
  YesNo
- Class Standing:*
  
  Not applicable/No college creditFreshmanSophomoreJuniorSenior
- Are you a current UNO Student?*
  
  YesNo
- If "No", are you:*
  
  a high school seniora transfer studentNever attended college (out of high school more than 4+ months)
- Most recent school attended:*
- What is your current or intended major and/or minor at the University of Nebraska at Omaha? (if undecided, write in “Exploratory Studies”) Major:*
- Minor (optional):
- Concentration (optional):
- Following graduation, do you plan to apply to graduate or professional school?*
  
  YesNo
- Family Income (Income documentation from independent students or from the parents/guardians of dependent students will be needed at the time of your scheduled appointment with Project Achieve Staff.)
- Taxable Income: $*
- Size of Household: (including yourself) *
- What is the highest level of education for your parent(s) or guardian(s)?
  (If only one parent or guadian add “Not applicable” to the second parent or guardian.)
- Parent/Guardian One:*
- Parent/Guardian Two:*
- Do you have a diagnosed disability? (This question is optional.)
  
  YesNo
- Support Services Needed: (Check All that Apply)*
  
  TutoringTest-Taking SkillsWriting SkillsReading SkillsResume WritingFinding a MajorInterviewing SkillsCourse SelectionMath SkillsLife PlanningAcademic AdvisingFinancial AdvisingPersonal Counseling
- Are you currently employed?*
  
  YesNo
- If “Yes”, where?*
  
  On-campusOff-campus
- How many hours a week?*
  
  1-56-1011-1920-2930+
- Have you been previously enrolled in Project Achieve?*
  
  YesNo
- Why do you want to participate in Project Achieve? Why and how can Project Achieve help you?*
- Tell us about a time you were able to achieve a goal. What was the goal? What helped you achieve it?*
- Tell us about a time you were not able to achieve your goal. What was the goal? What prevented you from achieving it?*
- Acknowledgements and Signature*
  
  I understand that Project Achieve TRIO SSS Program staff can assist me in achieving my goals only if I fulfill my obligation to take advantage of the services provided and that failure to meet my responsibilities can result in a suspension or termination from the program.I hereby attest that the information provided is true to the best of my knowledge, and I authorize the Project Achieve TRIO SSS Program to verify the information I have provided on my application and to access information related to my attendance, academic performance, and graduation, as well as other information necessary for the proper delivery of the program services. I also understand that if I'm accepted into the Project Achieve TRIO SSS Program, the information in my student file may be viewed by other agencies to which the Project Achieve TRIO SSS Program is accountable.If I'm accepted into the program, I authorize Project Achieve TRIO SSS Program to include information about and images of me in the program marketing materials,I'm accepted into the program.
- Signature:*
  
  Clear
- Date*
  
  MonthDayYear
  mm-dd-yyyy

PROJECT ACHIEVE APPLICATION