SSS-Webb City Application

ELIGIBILITY APPLICATION

Thank you for your interest in our Webb City Student Support Services program! Please complete this application as thoroughly as possible. You cannot save and restart this application. You may want to review the included items, take some time to make notes and gather the required documents, and then return to submit your application.

If you have any questions, please call our office at (417) 673-9208.

Visit our webpage for more program information.

How did you hear about the SSS program? *

General Information:

Last Name *

First Name *

Middle Name *

Gender *

Ethnicity/Race *

Date of Birth *

School ID *

Permanent Address *

Permanent Address 2

Permanent City *

Permanent State *

Permanent Zip *

Cell Phone Number *

Email Address *

Are you a U.S. Citizen? *

Education and Employment:

Did you receive a HS diploma? *

GED/HiSET?

Are you currently enrolled at Crowder College? *

If yes, how many total credit hours have you completed?

Future Educational Goals *

Are you currently employed?

If yes, how many hours per week do you typically work?

First Generation Status:

Please indicate the education level of your parents (Natural/Adoptive/Step) at the time of your 18th birthday

Mother: Obtained a Bachelor's (4 year) degree? *

Father: Obtained a Bachelor's (4 year) degree? *

Which parent did you regularly reside with and receive support from during your childhood (up to 18)? *

Have you ever been in foster care? *

Financial Aid Information

Have you completed your FAFSA for this academic year? *

Are you eligible for Federal Financial Aid? *

Dependent or Independent Status:

*Independent students generally are: 24 years of age or older; are married; have children; are orphans or wards of the court; are veterans; or have filed a petition for independent status with the Financial Aid Office.

Are you recognized as an Independent Student by the Financial Aid Office? *

Academic Need:

Academic Need *

Sign and Submit:

Applicant Signature *

Please select a signature verification type.

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Terms of Submission:

By submitting this application, you acknowledge that all of the above information is correct and accurate to the best of your understanding.

By submitting this application, you hereby authorize the release of your student academic and financial records to the SSS staff for the purposes of; assessing your program eligibility, assessing your need for services, monitoring academic progress, evaluating program effectiveness, fulfilling program‐reporting requirements, and advocating on your behalf with Crowder College campus partners.

By submitting this application, I understand that meeting minimum eligibility requirements is not a guarantee of my acceptance into the TRiO SSS Program at Crowder College- Webb City.