TRIO Student Support Services Application
This information is confidential. The following information is needed to determine membership for the program. Please complete the entire application and fill out each section entirely. An incomplete application will not be processed. After submitting your application, a member of the TRIO team will contact you via your LFCC student email account should we wish to bring you in for an intake interview to determine program fit and eligibility.
Student Demographic Information
First Name
Your answer
Last Name
Your answer
Street Address
Your answer
City, State, Zip
Your answer
Primary Phone Number
(with area code, no dashes)
Your answer
Date of birth
(MM/DD/YY)
Your answer
LFCC Student ID Number
Your answer
LFCC email address:
Your answer
Gender
Required
Marital Status
Citizenship status
Is English your first language?
Required
If no, what is your first language?
Your answer
Ethnicity
Are you Hispanic
Race
(check all that apply)
Required
In accordance with federal regulations, a student must meet one of the following criteria to be eligible for program services:
-A first generation college student (neither parent has a bachelor's degree)
-Low income (verified by a TRIO staff member and based on federal low-income guidelines)
-Have a documented learning, physical, mental or emotional disability
Does your mother have a bachelor's degree?
Required
Does your father have a bachelor's degree?
Required
With which parent did you primarily reside/receive support during childhood?
Required
Do you have a documented disability?
Required
If yes, have you registered with the LFCC Disability Coordinator?
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