TRIO Talent Search: Veteran & Adult Application 900 N. Portland Ave., City, OK 73107 405.945.9132 www.osuokc.edu/talentsearch

Student Information Last Name: First Name: Middle Initial:

Date of Birth: Social Security #:

Mailing Address:

City, State, Zip:

Student Cell Phone: Student Home Phone:

Student E-mail:

Sex: ❐ Male ❐ Female Are you a U.S. Veteran? ❐ Yes ❐ No Demographic & Household Information Are you a US Citizen? ❐ Yes ❐ No Ethnicity: Do you consider yourself Hispanic/Latino? If not, are you a Legal Resident? ❐ Yes ❐ No ❐ Yes ❐ No Race (Check all that apply): ❐ Asian ❐ Black/African American ❐ Native American/Alaska Native ❐ Native Hawaiian/Pacific Islander ❐ White/Caucasian

Who do you live with: ❐ Self ❐ Spouse ❐ Other: ______

Spouse’s/Other’s Name:______

Occupation:______Cell/Work Phone:______

What language is spoken at home? ______Do you have access to a computer at home? Do you have internet access at home? ❐ Yes ❐ No ❐ Yes ❐ No Education Information Educational Attainment: Highest grade or program completed Are you currently enrolled in school? ❐ Yes ❐ No

❐ Did not graduate/ no GED ❐ H.S. Grad./GED Current School: ______❐ College credits but below Bachelor’s Degree

If you are currently in school, what was your last semester’s grade point average (GPA)? (Check one) ❐ (A) 4.0 and above ❐ (B) 3.0 - 3.99 ❐ (C) 2.0 - 2.99 ❐ (D) 1.0 - 1.99 ❐ (F) below 0.99

If you are not in school, what are you doing? Are you currently a participant in another federal TRIO grant program? ❐ Yes ❐ No

Do you work? ❐ Yes ❐ No If yes, how many hours per week? ______

Where are you interested in going to college? (check all that apply) ❐ Rose State College ❐ Community College ❐ Oklahoma State University-Oklahoma City ❐ ❐ Oklahoma State University ❐ University of Central Oklahoma ❐ University of Science and Arts Oklahoma ❐ Southern Nazarene University ❐ Southwestern Oklahoma State University ❐ Metro Tech ❐ Francis Tuttle ❐ Other: ______

What are your career interests? ______Parent/Guardian Information TRIO Talent Search is a federally funded grant from the Department of Education and must document student’s eligibility. All information requested is for these purposes and will be kept strictly confidential.

Mother’s Education Level Father’s Education Level ❐ High School Degree/GED or Lower ❐ High School Degree/GED or Lower ❐ Associate’s Degree (2-year college degree) ❐ Associate’s Degree (2-year college degree) ❐ Bachelor’s Degree (4-year college degree) ❐ Bachelor’s Degree (4-year college degree) Income Verification For OSU-Oklahoma City to determine eligibility for Talent Search participation, federal regulations require a signed statement or written documentation of the applicant’s family size (# of exemptions) and taxable income from the last calendar year. Please complete only ONE of the sections below. Please call 405-945-9132 if you have any questions or need assistance locating this information.

Annual Taxable Income is located on your tax forms: line 43 on the 1040, line 27 on the 1040A and line 6 on the 1040 EZ.

Family Size: ______Annual Taxable Income: ______

For Families Who Were Not Required to File an IRS 1040 or 1040A Form:

Family Size: ______Total earnings (GROSS INCOME) for the previous tax year: $ ______Source of Income: ______

 By signing this form, I agree that all information contained on this application is true and correct to the best of my knowledge.  By signing this form, I understand the information conveyed and permit the receipt of program services.  I hereby release and forever discharge Oklahoma State University–Oklahoma City and its staff members from all manner of claims and responsibility due to any risks encountered by my participation.  I hereby authorize the OSU-OKC Talent Search Program to have access to my permanent school records during the application process and throughout the period of their participation in the program. I also give permission for the use of my name and /or photograph for editorial, promotional, recruitment or educational purposes.

❐ OPT-OUT of photography publication.

______Student Signature Student Printed Name Date

OSU-OKC Talent Search 900 N. Portland Ave. Oklahoma City, OK 73107 Phone: (405)945-9160 Fax: (405)945-9127

RECORDS RELEASE FORM To Be Completed By the Adult Student

 I hereby give permission for you to release any of my school records to the OSU-Oklahoma City Talent Search Program.

I authorize the release of school records from my file that may be requested by the Oklahoma State University-Oklahoma City (OSU-OKC) Talent Search Program. I understand that the OSU-OKC Talent Search Program will use these records to provide academic advisement and guidance for me. I also understand that these records will be handled in a confidential manner and that they will be made available only to program staff and representatives from Federal and State Departments of Education as required by law.

This authorization is limited to the following records:

 Official School Transcript  Student Academic Report with test scores  Student History File with tests scores  Test Results (PSAT, SAT, PLAN, ACT, COMPASS, etc., if available)  Basic Skills Test Results  Attendance Record  Student grades/progress reports  Information concerning disciplinary actions  Postsecondary enrollment and financial aid information  Postsecondary program certificate and/or degree completion records

Print Student’s Name: ______

Student’s Social Security Number: ______

Note: A photocopy of this record release form should be accepted as an original and the date indicated below has no bearing on when the information is requested by the OSU-Oklahoma City Talent Search Program.

Signature of Student (Required if student is over 18):______Date: ______

OKLAHOMA STATE UNIVERSITY-OKLAHOMA CITY TRIO TALENT SEARCH ADULT STUDENT NEEDS ASSESSMENT

NAME: ______DATE: ______

This survey contains a number of statements about student needs. Please give your honest opinion of how the Talent Search Program can meet your needs. Your answers will be kept confidential.

(Please Circle one) Pre-Enrollment NEEDS STRONG SOME NO NEED NEED NEED

1. Help with requirements for admission. 1 2 3 2. Help with FAFSA and financial aid. 1 2 3 3. Help with the admissions process. 1 2 3 4. Help with choosing a degree program. 1 2 3 5. Help with enrolling in college courses. 1 2 3 6. Help with scholarships. 1 2 3 7. Help with identifying, setting and evaluating goals for the future. 1 2 3

PERSONAL NEEDS

1. Help with transitioning into college. 1 2 3 2. Learn more about student clubs and organizations. 1 2 3 3. Learn more about student activities. 1 2 3 4. Help with individual needs. 1 2 3 5. Help meet other students with similar life experiences. 1 2 3

CAREER AND POSTSECONDARY NEEDS

1. Explore a variety of career opportunities. 1 2 3 2. Learn more about job applications, resumes and interviews. 1 2 3 3. Learn more about transferring to/from another college. 1 2 3 4. Prepare for the Compass or other college placement tests. 1 2 3 5. Learn more about campus learning resources (tutoring or other). 1 2 3