|
Brown Hall Suite 345, 105 West O Street, Russellville, AR 72801
trio.sss@atu.edu  (479) 880-4172
Â
|
Thank you for your interest in our Student Support Services program. Please complete this application as thoroughly as possible. You cannot save and restart this application.Â
Â
|
|
|
|
|
|
|
|
|
|
|
|
|
RACE & ETHNICITY: Please choose ALL that apply
|
|
American Indian or Alaskan Native
*
|
|
Black or African American
*
|
Hawaiian or other Native to Pacific Island
*
|
|
|
|
Did your Mother graduate with a 4 year bachelor's degree?
*
|
Did your Father graduate with a 4 year bachelor's degree?
*
|
|
|
Do you have a documented physical or learning disability?
*
|
If Yes, have you registered with Tech's Disability Services?
|
Upload a copy of your disability accommodations letter from your online portal
|
|
Have you completed the FAFSA?
*
|
Check box if you are receiving Student Loans
|
Check box if you are receiving Scholarships
|
Check box if you are receiving work-study
|
Check box if you are receiving pell grant
|
|
|
When you are not in school, who do you reside with?
*
|
How many people are in your family/ live in your household? (Include those away in school and yourself)
*
|
Do you have any children?
*
|
|
Academic Need: Check all that apply (must check at least one)
|
|
|
Low Admission Test Scores (ACT, SAT, ACCUPLACER
|
|
Out of school for more than 5 years
|
Limited English Proficiency
|
Lack of educational/career goals
|
Lack of Academic Preparedness
|
Need for academic support to raise grades in required courses/major
|
Check the services which are of greatest need (must check at least one):
|
|
|
|
Financial Aid Information
|
|
|
|
|
|
How did you learn about Student Support Services?
|
SIGN AND SUBMIT:
Student Informed Consent Agreement
I certify that the information I have provided is true and correct to the best of my knowledge. I give my consent for Arkansas Tech University Student Support Services Program to release and receive academic and/or financial aid information in order to provide appropriate services.
|
Click here to start signing.
|
Click here to start signing.
|
|