Program Application

Thank you for your interest in the TRIO SSS program! Please complete this application as thoroughly as possible.  This application cannot be saved, so plan on completing it in one sitting. If you have any questions, please call our campus office at 509.527.4258 or email TRIOSSS@wwcc.edu 
Today's date *
First Name *
Last Name *
WWCC Student ID # *
Why do you want to join the TRIO program? *
Date of Birth *
Local Address *
Local Address 2
Local City *
Local State *
Local Zip *
Permanent Address if different from local address
WWCC Student Email Address
Secondary Email Address
Local Phone
Cell Phone Number
Preferred Contact Method *
ELIGIBILITY
US Citizen? *
If NOT a US Citizen, are you a Permanent Resident?
If Permanent Resident, please select from the categories in the drop down list. Individuals who meet one of these definitions are considered an "eligible non-citizen"
Does either one of your parents have a Bachelors degree (4-year college)? *
Do you have a documented disability? *
If YES, have you self-identified through our DSS Office in Student Services?
If YES, may we confirm your disability status with the DSS Office at WWCC?
FINANCIAL INFORMATION
Have you filed a FAFSA (Free Application for Federal Student Aid)? *
What is your dependency status? (Acc'd to the FAFSA, if you are under the age of 24, or do not have a child, or are unmarried, or are not a foster student, or not at risk of homelessness, you are considered a dependent student) *
How many people live in your household? *
Did you or your parents (if you are a dependent) file a tax return last year? *
Do you know your taxable income for last year (Form1040-line 15)? (If you are considered a dependent student acc'd to the definition above, this will most likely be your parent's tax information) *
If YES, please enter your taxable income (or your parent's)
Do you have any other income sources? Please list (e.g. DVR, SSI, BFET, Opp grant, TANF or food stamps. scholarships, savings, parent help, worker retraining grant, etc.)
ACADEMIC INFORMATION
Are you currently enrolled at WWCC? *
If YES, how many credits are you currently taking?
What is your current academic standing?
Education Achieved - please select and complete all that apply:
GED or High School Diploma
Date graduated
Name of school attended
Some college/no degree
Year(s) attended
Name of college(s) attended
Vocational Certificate
Date graduated
AA, AS, or AAS
Year graduated
Bachelor's degree
Date graduated
What WWCC degree are you pursuing? *
Are there any colleges you are interested in transferring to after WWCC?
What is your intended major at a 4-yr college?
What is your career or occupational goal? *

DEMOGRAPHIC INFORMATION
Gender
What is your ethnicity? *

What is your race? MARK ONE or more races to indicate what you consider yourself to be:

  • American Indian or Alaska Native: A person having origins in any of the original peoples of North and South America (including Central America), and who maintains tribal affiliation or community attachment.
  • Asian: A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent, including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam.
  • Black or African American: A person having origins in any of the black racial groups of Africa. Terms such as "Haitian" or "Negro" can be used in addition to "Black or African American."
  • Native Hawaiian or Other Pacific Islander: A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands.
  • White: A person having origins in any of the original peoples of Europe, the Middle East, or North Africa.
Race, American Indian or Alaskan Native
Race, Asian
Race, Black or African American
Race, Hawaiian or other Native to Pacific Island
Race, White
How did learn about TRIO? *
Name of person who referred you to TRIO
SIGNATURE

By signing and submitting this application, I certify that the  information entered above is correct and accurate to the best of my knowledge. I understand all information I share with TRIO will be kept strictly confidential, and information from other offices at WWCC may be requested to complete my TRIO file. 

PLEASE NOTE: That you must use the signature pad to Sign and submit your signature, then click the Submit Application button after you signature has been accepted.  If your submission was successful, you will see a message that says: "Thank you for applying ..."
Utilizing the Signature Pad, please provide your E-signature *
Please select a signature verification type.