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Academic Achievement

Program Eligibility Application

Student Support Services (SSS) is a federally funded program which supports eligible students in the completion of their undergraduate degrees. Students who qualify, and are inducted into the program, can utilize its services free of charge. Central Washington University’s Student Support Services Program offers the following:

  • Comprehensive Academic Advising
  • Academic Tutoring
  • Academic and Career Workshops
  • Career Exploration
  • Cultural, Social, and/or Leadership Activities
  • Financial Literacy Programs
  • Assistance in Applying to Graduate Schools and Financial Aid

Please answer the following questions below to determine your eligibility to participate in the program:

Basic Personal Information
Please include any hyphens, spaces, maiden names, given names, etc. as they exactly appear on your university records.
Campus Information
Personal Information

We realize that these categories are not all inclusive of the broad range of Race/Ethnicity options. However, we are bound by federal reporting requirements.

Education
CWU Information
You are only eligible for enrollment in TRiO SSS if you are accepted or currently enrolled at Central Washington University.
Please note, we are based on the Ellensburg campus.
Mother's or Guardian's Education Level

If you do not know or if this infomation is unavailable, please use "0"

Father's or Guardian's Education Level

If you do not know or if this infomation is unavailable, please use "0"

Digital Signature
As a CWU student, please type BOTH your first and last name (s) as they appear on your official CWU records.
Please type BOTH first and last name(s) as they appear on your official documents.

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.

Please indicate the areas which you would like assistance
Student with a Disability Verification
Low-Income Verification

Please Note:  If you are provided an offer to be inducted into the CWU TRiO SSS Program, we will ask you to provide paper-based verification of this information in the form of your current Income Tax Form and/or your FAFSA Form.  Please make certain that you have access to these documents if we should ask for them to ensure that we can process your application effectively.

Section A - Independent Student
Your actual of estimated Taxable Income form most recently filed tax form (Found on IRS Form 1040, line 43; 1040A, line 27; 1040EZ, line 6).
Section B - Dependent Student
Your actual of estimated Taxable Income form most recently filed tax form (Found on IRS Form 1040, line 43; 1040A, line 27; 1040EZ, line 6).
Digital Signature
As a CWU student, please type BOTH your first and last name (s) as they appear on your official CWU records.
Please type BOTH first and last name(s) as they appear on your official documents.
STEP 3: Additional Information
Please select all that apply

Privacy Information Act

Privacy Information Act

In accordance with the Privacy Act of 1974 (Public Law No. 93-579, 5 U.S. C. 552a), you are hereby notified that the Department of Education is authorized to collect information to implement the Student Support Services Program under Title IV of the Higher Education Act of 1965, as amended (Pub. Law 102-325, Sec. 402D). In accordance with this authority, the Department receives and maintains personal information on participants in the Student Support Services program. The principle purpose for collecting this information is to administer the program, including tracking and evaluating participant progress. The information that is collected on this form will be retained in the program files and may be released to other Department officials in the performance of their official duties.

By signing this, I grant permission to Student Support Services to track all of my academic progress at CWU. I hereby authorize the release of my student academic and financial aid records for the SSS professional staff to use to discuss with me and if appropriate my instructor in order to better assess my academic progress (CWU already has this contract with them.   Should we repeat it for emphasis?). I understand that my instructors may be contacted during the quarter to evaluate my class progress. All of my CWU TRiO SSS information will be available to me upon request.

Digital Signature
As a CWU student, please type BOTH your first and last name (s) as they appear on your official CWU records.
Please type BOTH first and last name(s) as they appear on your official documents.
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