TRIO Student Support Services

TRIO STUDENT SUPPORT SERVICES APPLICATION

Please complete all questions and submit with your electronic signature. Minnesota North College's TRIO SSS office will review your application and determine eligibility to participate. After becoming a member, your TRIO SSS academic advisor will be assigned based on your home campus and the two of you will meet to go over your academic needs to develop an action plan for success.

OFFICE USE ONLY - APPLICATION REVIEW & ELIGIBILITY DETERMINATION 5021-LIFG 5022-LI 5023-FG 5024-D 5025-DLI

This application will be processed for Mesabi Range Campus in Eveleth or Virginia, MN.

Select your home campus: *

General Information

First Name *

Middle Initial

Last Name *

Star ID, ie., ab####yz *

College Student ID #

Date of Birth *

Gender Identity (select or enter below)

Prefer to Self-Identify Gender

Preferred Email Address *

Cell Phone Number

Check if you prefer to opt out of text messages

Watch for a text message later in semester asking you to officially opt-in for SSS text messages. Simply reply YES.

Background Information

Please respond to ethnicity, race, and other background questions as indicated below:

Is your ethnicity Hispanic or Latino? *

From the following race options listed below, please answer Yes to one or more that you identify with.

American Indian or Alaskan Native *

Asian *

Black or African American *

Hawaiian or other Native to Pacific Island *

White *

What is your residency status? *

Do any of these apply to you? (Homelessness or Foster Care)

Are you a Veteran? *

If yes, check box if the college has received your joint services transcript (JST).

How many prior college institutions have you attended?

If you did take college classes before, from where? List college(s):

List any college certificate/degrees earned:

What is your current admission status? *

What semester will be your first term of enrollment? *

Program Eligibility

SSS will verify your first-generation college-going status from your college application. Generally, this means that neither parent has earned a 4-year degree, although there are other qualifiers we review.

Check box if you know you are a First Generation college student.

Check box if you have a documented disability (i.e., physical, mental health, learning)

Have you completed your application for financial aid using the FAFSA? *

How would you self-identify your eligibility to participate in TRIO SSS? *

Select one area of academic need that you most identify with *

If you selected "OTHER" in previous question, list your academic need:

Choose One: *

Parent or Contributor First Name

Parent or Contributor Last Name

Parent or Contributor Email

Parent or Contributor Email (incase email doesn't work)

Supportive Services

During your program intake, SSS will go over your academic and personal needs along with the supportive services TRIO Student Support Services can offer and provide to students.

Sign and Submit

I certify the information given on this application is true and correct to the best of my knowledge. I hereby authorize TRIO Student Support Services to obtain my records or data pertinent to my participation in the program from College Admissions, Accessibility Services (if applicable), Financial Aid, Registrar, the National Student Clearinghouse, and my parent or contributor for the FAFSA. I also authorize the college or professional associated with it to access and release data for purposes of my academic success or TRIO project audit or evaluation. Photographs taken by my participation in TRIO activities may be used in TRIO publications. I understand this authorization may be revoked by me at any time through written or verbal communication.

To electronically sign this application, provide your signature using one of the available options.

Select signature type and then Submit Application button to proceed *

Please select a signature verification type.