TRiO Application

* Required Information

Personal Information

*First Name *Middle Initial *Last Name
*Date of Birth / / (yyyy)
*Gender
*Student ID #
Your student ID number can be found in your Acceptance Letter or on the back of your Hawkeye card in the bottom left corner. You must enter all seven digits of your ID. Your Student ID number may start with zeros.
*Phone *Email
*Current Address
 
*City *State *Zip
 
*Permanent Address Same as current address
 
 
City State Zip
*Are you Hispanic or Latino?
  If No, please select one or more races:
(This data will be used only to comply with regulations established by the U.S. Department of Education)
 


Eligibility Information

*Parent's Educational Background


*Estimated Taxable Income $ *Family Size (including yourself) *Marital Status
*Do you have a diagnosed learning or physical disability?   
*Are you a U.S. Citizen?   
*Are you a Permanent Resident?   
Have you participated in any of the following programs?
             
  If yes, what college(s) sponsored the program(s)?

Academic Information

*Student Status   
*Hawkeye Enrollment Date    *Year (yyyy
*Highest level of education completed
*Program of Study
*How many credit hours are you currently enrolled in?
*Do you intend to earn a degree at Hawkeye?   
*What transfer colleges are you considering?

Financial Aid Information

*Have you applied for financial aid?   
*If yes, please check your financial aid sources
  Iowa Vocational Technical Grant
Employer Pell Grant
  Vocational Rehabilitation Student Loans SEOG
  Scholarships Other (please specify)  

TRiO-Student Support Services Program Expectations

I agree to utilize the TRiO-Student Support Services Program/Staff and Hawkeye Community College facilities to help me be academically successful with my program of study.

I agree to allow TRiO-Student Support Services staff to access current income eligibility data filed through the college Financial Aid office.

I have been offered sufficient financial assistance to meet my full financial needs (as assessed by the Financial Aid office under federal guidelines) or will seek my own sources to meet my direct and indirect academic financial needs.

I agree to allow the TRiO-Student Support Services staff to access Hawkeye Community College academic records, monitor my academic progress through communication with faculty, and other student support staff and obtain a copy of my grades each term.

I agree to allow TRiO-Student Support Services staff to share information in my TRiO-Student Support Services file with other TRiO programs for the purpose of determining program eligibility and transfer procedures.

I certify that the above information is true and correct to the best of my ability. I understand that the information supplied on this application is and will be kept confidential.

By submitting your TRiO Application you agree to the terms of the TRiO-Student Support Services Program Expectations.

If you are not redirected to a confirmation page once you have submitted your TRiO Application, please check to be sure you have completed all the required information.

TRiO

Bremer Hall 120
319-296-2329 ext.1803

Project Director

Ruben Carrion
319-296-2329 ext.1803
Email me

Advisor

Stacey Reicherts
319-239-2329 ext.1804
Email me

Advisor

John VonTersch
319-296-2329 ext.1805
Email me

Writing Instructor

Lynn Blair-Broeker
319-296-2329 ext.1806
Email me

Mathematics Instructor

Darrell Jesse
319-296-2329 ext.1807
Email me