Inclusion and Success Services Application

All fields marked with * are required.

Personal Information

(7-digits) Where do I find my Student ID #?
(yyyy)






This data will be used only to comply with regulations established by the U.S. Department of Education

Eligibility Information







Academic Information




Year *







Financial Aid Information








Inclusion and Success Services Program Expectations

By submitting this application, you agree to the following terms:

  • I agree to utilize the Inclusion and Success Services program/staff and Hawkeye Community College facilities to help me be academically successful with my program of study.

  • I agree to allow Inclusion and Success 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 Inclusion and Success 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 Inclusion and Success Services staff to share information in my Inclusion and Success Services file with other 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.

You will see a confirmation screen once your application has gone through. If you do not see a confirmation screen, scroll up and complete missing required information.

Contact Information

TRIO

Bremer Hall 136
319-296-2329 ext.1803

Visit with us via our Zoom online office

Project Director

Jen Beck
319-296-2329 ext.1803
Email Jen Beck

Advisors

LaCreeci Moss
319-296-2329 ext.1804
Email LaCreeci Moss

Kizzy Brown
319-296-2320 ext.1805
Email Kizzy Brown

Writing Instructor

Jennifer Coulter
319-296-2329 ext.1806
Email Jennifer Coulter

Mathematics Instructor

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

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