Academic Achievement

Program Eligibility Application

Dear Prospective TRiO Student Support Services (SSS) Participant,

By completing and electronically submitting this online form, you will be completing the first step of Central Washington University's (CWU) TRiO SSS application process. Please note that, in order to be considered as a potential participant of TRiO SSS, you must be accepted or enrolled at CWU.

Next you will need to submit a physical copy of the signed Release Form (found here) declaring that the information you have submitted is accurate and complete to the best of your knowledge. It also confirms that you understand that the TriO SSS staff will be able to access your academic records. You may submit this form by: (1) physically visiting our office in Hertz Hall 209 on Central's main campus in Ellensburg; (2) mailing the form to the address below, or (3) faxing the signed form to the TRiO SSS Office at 509-963-1620.

Your application and release form will be placed in a candidate pool that we will then select from to establish our 2013 – 2014 cohort. If you are not notified by June 30, 2013, please contact our office directly at 509.963.2026.

Central Washington University
400 E. University Way
TRiO SSS Hertz Hall 209
MS 7430
Ellensburg, WA 98926

Thank you in advance for your interest in the TriO Student Support Services Program.

Fields marked with an * are required.

Last Name *

Middle Initial *

First Name *

Student ID Number

Email *

Permanent Address *

City *

State *

ZIP *

Campus Address (Current)

City

State

ZIP

Contact Phone Number *

format: xxx-xxx-xxxx

Date of Birth *

Month

Day

Year

What is your gender?

Male

Other

Female

Ethnicity (optional)

Are you a U.S. Citizen? *

Yes

Are you a Permanent Resident?

Yes

If yes: A#

Are you currently enrolled or accepted at CWU? *

Yes

You are only eligible for consideration for enrollment in TRiO SSS if you accepted or currently enrolled at Central Washington University.

Do you have a qualifying disability? *

Yes

If yes, have you submitted documentation of your disability with CWU's Disability Support Services?

Yes

What options are you considering as a major *

Do you have a Bachelor's degree? *

Yes

Mother's or Guardian's Education Level

Highest Grade Level Completed *

Years of college competed, if any

Highest Degree Earned, if any

Father's or Guardian's Education Level

Highest Grade Level Completed *

Years of college competed, if any

Highest Degree Earned, if any

Have you applied for financial aid? *

Yes

If you did not apply for financial aid and wish to be considered for TRiO SSS under the low-income eligibility criteria, please call 509-963-2026 regarding the Federal tax return information you need to submit.

Have ever participated in any other TRiO Programs? Check all that apply.

Student Support Services

Upward Bound

Upward Bound Math Science

Educational Talent Search

Veterans Upward Bound

Educational Opportunity Center

Indicate location(s) of previous programs and name(s) of the school(s) or agency.

How did you hear about CWU's TRiO Student Support Services? *

Please tell us briefly (75-250 words) why you want to participate in CWU's TRiO SSS Program? *

A copy of SSS Release Form is required in order for your application to be considered. For instructions how to submit the form, please go to the Apply to TRiO page located on our lefthand menu.

News

SSS Fall 2012 Newsletter

SSS Winter 2012 Newsletter

SSS Fall 2011 Newsletter

Academic Achievement Calendar

April 2013

S	M	T	W	T	F	S
	1	2	3	4	5	6
7	8	9	10	11	12	13
14	15	16	17	18	19	20
21	22	23	24	25	26	27
28	29	30

Search form