TRIO EOC 2020-21 Outreach Intake Form
The TRIO EOC is funded by the Department of Education with the goal of serving 1,000 participants to attend any 2-year or 4-year college/university. Please complete this confidential form to authorize the TRIO EOC program to serve you with any of the following in person or virtual college access services: FAFSA and Admission Application Completion, Financial Aid Follow-up, College Information, Scholarship Search, Student Loans, Transfer Assistance, Academic & Career Counseling, GED Information, or a Defaulted Student Loan. We serve the residents of Franklin, Halifax, Henry, Patrick, and Pittsylvania Counties and the cities of Danville and Martinsville.
What is your first name?
What is your last name?
Date of Birth
Are you Hispanic or Latino?
American Indian or Alaska Native
Black or African American
White or Caucasian
Native Hawaiian or Other Pacific Islander
Two or more races
Are you "Military-Connected" as a
Child of Active Duty
Spouse of Active Duty Military
Gender, assigned at birth
How many are in your household / How many are your dependents? Example 4/0
Does your Mother have a (4-year) bachelor’s degree?
Does your Father have a (4-year) bachelor’s degree?
Taxable Income from IRS Form 1040, line 10
$ 0 --- 19,140
19,141 --- 25,860
25,861 --- 32,580
32,581 --- 39,300
39,301 --- 46,020
46,021 --- 52,740
52,741 --- 59,460
59,461 --- 66,180
more than 66,181
Additional Sources of Income:
Are you Employed?
My intent is to enroll in:
Program of study I intend to enroll in:
I need assistance with (Check all that apply):
Defaulted Student Loan
Your Educational Status as of Today:
Studying for GED
Enrolled in High School
High School Graduate
Enrolled in College
College Stop-Out (2+ Semesters)
Are you currently participating in a high school Talent Search Program?
How did you hear about our Educational Opportunity Center?
Please select from the following list of Workshops and submit. The Workshop link will be emailed 24 hours prior to the event.
Creating Your FSA ID Workshop
Detailed workshop of how to successfully create your FSA ID to apply for financial aid.
Tuesday, September 29 @ 12:00 pm
Tuesday, September 29 @ 6:00 pm
Wednesday, September 30 @ 12:00 pm
Wednesday, September 30 @ 6:00 pm
College Awareness 101 (Recorded)
Information on how and when to apply to college, SAT/ACT standardized testing, paying for college, and other important details.
FAFSA Fever Workshop
Detailed information about completing the 2021-22 Federal Application for Student Aid (FAFSA).
Thursday, October 8 @ 6:00 pm
Thursday, October 15 @ 6:00 pm
Thursday, October 22 @ 6:00 pm
Thursday, November 12 @ 6:00 pm
Thursday, December 10 @ 6:00 pm
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This form was created inside of Virginia's Community Colleges.