| * Required Fields |
| *: |
|
| *: |
|
| : |
|
| *: |
|
| *: |
|
| *: |
|
| *: |
|
| *: |
|
| *: |
(xxxxx-xxxx) |
| : |
(xxx-xxx-xxxx) |
| *: |
|
| *: |
|
| *: |
|
: |
|
| *: |
|
: |
|
| *: |
HS Student
HS Incomplete(no HS Diploma or GED)
College Incomplete(did not receive a degree)
HS/GED Graduate
College Student
College Graduate
|
| *: |
Yes
No
|
| *: |
Yes
No
|
| *: |
Yes
No
|
Income: Total Annual Household Income (taxable and non-taxable) for 2005. Please include public assistance (AFDC or other), Social Security, Child Support or Other. |
|
less than $15,315
$15,315-$20,534
$20,535-$25,754
$25,755-$30,974
$30,975-$36,194
$36,195-$41,414
$41,415-$46,634
$46,635-$51,854
$51,855+
|
| *: |
|
| : |
GED/HS Completion
Scholarships
Locating a college or vocatonal school
College Admissions
Career Information
GED Information
Financial Aid/FAFSA
Other
|
*: |
|
Educatonal Needs Assessment Plan (ENAP) |
| : |
Time management and environment
Financial appeal letter
Reading textbooks
Preparing for tests
Taking tests
Other
|
*: |
|
| Career Profile |
| :
|
|
|
(include those things you have considered doing for pay because you enjoy them or because you do them well) or short or long term goals:
|
What college(s) or Vocational School(s) are you considering? |
|
|
|
|
|
|
|
|
| If yes, |
|
|
|
|
How did you hear about the Texas Southern University Educational Opportunity center (TSUEOC)? |
|
Referral from TRIO Program Staff
Referral from another Service Agency
College Financial Aid Office
High School Counselor
Poster/Flyer
Newspaper
EOC Workshop
Friends
Radio
|
Educational Goal(s): |
My Educational Goal is to: |
|
Obtain an Associate Degree from a two-year college
Obtain a Bachelors degree
Obtain a Certificate or License from a two-year college or business/vocational school
Obtain a Masters or Doctorate
Attend a Professional School upon completion of a Bachelors Degree (Law, Medical, etc.)
Enlist in the Armed Forces to complete postsecondary education/training
|
|
