TRIO Veterans SSS Application

Boise State Student ID Number *

If you are not currently enrolled at BSU, please visit our sibling program, Veterans Upward Bound

Preferred Name *

Full Name *

First Middle Last

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Boise State Email Address *

Date of Birth *

Gender *

Ethnicity *

Did your parent(s), natural or adoptive, graduate with a bachelor’s degree prior to you turning 18? *

As part of the terms of our federally funded grant, TRIO programs identify and serve students who are first-generation college students. As such, we use the information above to partly determine your eligibility for Veterans SSS.

Yes

TAXABLE net income (not gross) from current year OR previous year's tax return: LINE 15 from 1040 IRS form. Do not include disability income, alimony, overseas pay, housing allowance or child support *

Do you have a documented disability or disability rating *

As part of the terms of our federally funded grant, TRIO programs serve students with documented disabilities. This could include physical disabilities and/or learning disabilities. This information will not be used or shared for any other purpose other than understanding your eligibility for Veterans SSS.

Yes

Applied for – Pending Rating

Branch of Service *

Are you a U.S. Citizen? *

Yes

Have you submitted a Free Application for Federal Student Aid (FAFSA) for the current academic year? *

Yes

TRIO uses Federal Financial aid information to partly determine your eligibility for services. Please complete the FAFSA here.

Are you currently enrolled in a TRIO SSS program at Boise State University: TRIO Rising Scholars, TRIO STEM Scholars, TRIO Teacher Prep, or TRIO ACES? *

Yes

If yes, which program? *

TRIO Rising Scholars

TRIO STEM Scholars

TRIO Teacher Prep

TRIO ACES

Have you previously participated in any TRIO programs? *

Yes, Veterans Upward Bound

Yes, high school Upward Bound

Yes, high school Talent Search

What is your major or what do you hope to study? *

What academic year are you in? *

Briefly explain your academic and career goals. *

Ex: I want to complete the social work degree program and work in the corrections field.

In a few sentences please explain what support systems you have. *

Ex: My parents and partner are very supportive of my academic goals.

What do you hope to gain by working with TRIO Veteran Student Support Services? *

Ex: I need support navigating the VA and GI Bill system. I would like more guidance in my career possibilities. As a nontraditional student I want to find a community here at Boise State University.

How did you hear about TRIO Veteran SSS? *

Image Release Statement

The VSSS facilitates events that support student success and we often take pictures or videos that include the names and/or images of participants. Please read the disclaimer and check the box to indicate your permission to use your image in relation to VSSS activities. As the VSSS participant my image may be used in relation to Veterans Student Support Services (VSSS) activities, which could take the form of a photograph, video, and/or be used on the VSSS website or social media. I understand that only my name and/or image(s) will be used, and under no circumstances will any other personal or confidential information be published.

Image Release Authorization *

I grant permission

I do not grant permission

Program Release Statement

Submitting this form authorizes the Boise State University TRIO Veterans SSS Program to obtain necessary academic, financial, and personal information (this includes demographic and contact information, transcripts, admission, enrollment, financial aid eligibility, US residency status, and income verifications through FAFSA), for the purpose of determining eligibility, developing education plans, record keeping and collecting program statistics.

Agreement and Signature *

I hereby attest that, to the best of my knowledge, the information given in this application is true, complete and accurate.

Agree

Disagree

Applicant Signature

Electronic Signature *

Please type your first and last name below

Date *