FCEA TRIO Application

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YoutubeIf you're wondering how TRIO Talent Search can help you watch this short video featuring Talent Search senior, Lajahne' Long!
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What Program do you intend to Join?* This field is required.
EOC
Talent Search
Upward Bound
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Name* This field is required.
First Name
Last Name
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Parent Name* This field is required.
First Name
Last Name
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Student Social Security Number* This field is required.
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Student Email* This field is required.Please use your most current email
example@example.com
Email Verified
The verification code has been sent to some@email.com
Please check your mailbox and paste the code below to complete verification
••••
Didn't receive verification code? or
Receiving the email may take a few minutes, thank you for your patience!
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Parent/Guardian Email* This field is required.Please use your most current email
example@example.com
Email Verified
The verification code has been sent to some@email.com
Please check your mailbox and paste the code below to complete verification
••••
Didn't receive verification code? or
Receiving the email may take a few minutes, thank you for your patience!
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Student Phone Number* This field is required.Please use your most current email
Area Code
Phone Number
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Parent/Guardian Phone Number* This field is required.Please use your most current email
Area Code
Phone Number
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Home Address* This field is required.Please use your most current address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
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What school/college do you currently attend? * This field is required.
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School Student ID# * This field is required.If you do not have one please put the numbers 9
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What is your current grade level?* This field is required.Please record the grade level that you were in before August 2021. (example: I just finished my junior year in May, so I will put that I am a junior.)
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What is your GPA? * This field is required.It's okay if you're not sure!
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What is your ethnicity?* This field is required.
Hispanic
American Indian/Alaskan Native
Asian
Black/ African American
White
Native Hawaiian or other pacific islander
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Gender* This field is required.
Male
Female
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Do you have an IEP (individualized academic plan) or RTI (response to intervention) on file with the school district ?* This field is required.
YESNO
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Are you or your child currently involved in another TRIO Program?* This field is required.
Talent Search
Upward Bound Math-Science
Veterans Upward Bound
Educational Opportunity Centers
Gear Up
Other
None
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Student Birth Date* This field is required.
Date
Year
Month
Day
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Student Age * This field is required.
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High School Graduation Year * This field is required.
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Are you a U.S. Resident? * This field is required.
YESNO
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If not, are you a permanent resident? * This field is required.
YESNO
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Are you you in foster care? * This field is required.
YESNO
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Enter Permanent Resident Alien Number:* This field is required.(if applicable)
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Are you homeless? * This field is required.
YESNO
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Has your father received/earned a four-year degree? If so at what school? * This field is required.
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Has your mother received/earned a four-year degree? If so at what school?* This field is required.
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Which parent did you regularly reside with and receive support from* This field is required.
Mother
Both Mother & Father
Neither Mother or Father
Father
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Are you in college and working on a master's or doctorate program? * This field is required.
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Are you married?* This field is required.
YESNO
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Do you have children who receive more than half of their support from you?* This field is required.
YESNO
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Do you have dependents (other than your children or spouse) who live with you* This field is required.
YESNO
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Are both of your parents deceased, or are you (or were you until age 18) a ward/dependent of the court?* This field is required.
YESNO
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Are you a veteran of the U.S. Armed Forces?* This field is required.
YESNO
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What is the total number of persons in your house hold? * This field is required.How many people live in your home? Include all parties such as grandparents, cousins, or family friends
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My family’s taxable (not total) income from the last calendar year was?* This field is required.Your taxable income can be found on the federal income tax return you filed for the last calendar year . On IRS Form 1040, see line 43. On IRS Form 1040A, see line 27. On IRS Form 1040EZ, see line 6. On IRS Telefile, see line K1
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I attest that my family did not file a federal income tax return for the last calendar year.* This field is required.
Clear
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I attest that I had no taxable income for this year (2020-2021) and the information that I provided above is accurate.
Clear
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If possible, can you upload a copy of your 1040 tax return, your medical card, or your SNAP benefits letter? This can be sent through PDF or in a simple screenshot. Providing us with this information allows us to determine your income eligibility for the program.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
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Please add a copy of your child's unofficial transcript
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
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I attest that my child has entered into the next grade level
YESNO
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What is the value of a good education and how will Talent Search or Upward Bound Contribute to your success? * This field is required.Please type at least 5 sentences
Huge
Large
Normal
Small
Ok
Ok
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Student Signature: By signing this application, you attest that all the information on this application is true. Moreover, you authorize the release of official school records to The Family Centered Educational Agency, understanding that the information in these records will be used only to assess the student’s need for program services, discern his/her educational progress, evaluate the effectiveness of program activities, and fulfill program reporting requirements. Also I authorize for any pictures/videos taken in connection with the activities of the FCEA TRiO Programs (Upward Bound and Talent Search) to be used in publications.* This field is required.
Clear
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Student Name* This field is required.
First Name
Last Name
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Parent Signature: By signing this application, you attest that all the information on this application is true. Moreover, you authorize the release of official school records to The Family Centered Educational Agency, understanding that the information in these records will be used only to assess the student’s need for program services, discern his/her educational progress, evaluate the effectiveness of program activities, and fulfill program reporting requirements. Also I authorize for any pictures/videos taken in connection with the activities of the FCEA TRiO Programs (Upward Bound and Talent Search) to be used in publications.* This field is required.
Clear
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Parent Name* This field is required.
First Name
Last Name
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The 20 federal TRIO Programs low- income level for a family unit of blank is _______________ .
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Advisor Signature
Clear
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Advisor Name
First Name
Last Name
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Advisor Approval
Recommended
Not Recommended
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Principal Investigator Signature
Clear
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Principal Investigator Name
First Name
Last Name
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Principal Investigator Approval
Recommended
Not Recommended
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Director Signature
Clear
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Director Name
First Name
Last Name
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Director Approval
Recommended
Not Recommended
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Date of Application Entry into Database
Date
Year
Month
Day
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Name of Data Entry Staff
First Name
Last Name
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Eligibility
LI & FG
LI & AT RISK
LI, FG, & AT RISK
LI ONLY
FG ONLY
FG & AT RISK
AT RISK ONLY
OTHER
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Low GPA
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Pre- Algebra/Algebra not completed by the 10th Grade:
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Desired Project
TS Thornton
UB Awesome
TS Thornwood
UB PROMISE
UB SENIOR
UB RISING
UBMS-CC
Should be Empty: