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TRIO-SSS Student Application

TRIO-SSS is 100% funded by the United States Department of Education is hosted by Iowa Lakes Community College. Funded for 2020-21 is $323,755.00

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Part 1: Personal Data
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Will you be living in the dorms?:
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Gender:
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Are you a U.S. Citizen?:
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Ethnic Group:
Please mark all that apply to you:
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Have you attended another college?:
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Have you participated in the following TRIO programs?:
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Did you plan on or are you thinking about transferring to a four-year institution?:
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Did you graduate high school?:
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Part 2: Need
Please identify areas of need:
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Part 3: Verification
Do you have a documented mental, physical and/or learning disability?:
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Have you applied for Financial Aid and completed the FAFSA form?:
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Part 4: First Generation Student Verification

The term “first generation college student” means:

  1. An individual whose parents did not complete a baccalaureate (bachelor’s or 4-year college) degree, or
  2. In the case of an individual who regularly resides with and receives support from only one parent, that parent did not complete a bachelor’s or 4-year college degree

What is the highest education level your father and mother have completed? (Check one for each parent)

Father:
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Mother:
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Under the above definition, I am a "first generation college student":
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Part 5: Dependency and Financial Verification

Independent Student Status

I am considered an independent student. Please check how you are considered an independent student:
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DEPENDENT STUDENT STATUS

I am considered a dependent student, (typically younger than 24, unmarried, parental income is reported on the
FAFSA). We need YOUR PARENTS’ taxable income amount from the previous year.

If you are considered a dependent student, please have your parents complete the TRIO-Student Support Services Financial Eligibility Verification Form. This form needs to be completed and returned before we can process your application. The form can be returned to room 9 on the Estherville campus or room 240 on the Emmetsburg campus.

Part 6: Release of Information & Affidavit of Truth Statement

By signing this application, I verify that the information provided on both sides are true and accurate to the best of my knowledge. I authorize TRIO-SSS staff to gather and verify information concerning the eligibility requirements for the program; income, documented disability and dependency status. I also grant permission for TRIO-SSS staff to access and gather information concerning my academic records, academic progress, class attendance, and allow collaboration with Iowa Lakes Community College faculty and staff concerning all the above.

Electronic Signature Agreement: You agree your electronic signature is the legal equivalent of your manual signature on this application. You agree that your signature on this document is as valid as if you signed the document in writing.
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 Print your name.
Draw your signature.
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