Thank you for your interest in our TRIO Student Support Services program. Please complete this application as thoroughly as possible.

If you have any questions, please call the office at 479-788-7355.


General Information:
Last Name *
First Name *
Date of Birth *
Address *
Address 2
City *
State *
Zip *
Cell Phone Number
UAFS Email Address *
UAFS ID Number *
Gender *
Race, American Indian or Alaskan Native *
Race, Asian *
Race, Hawaiian or other Native to Pacific Island
Race, Hispanic *
Race, Black or African American *
Race, White *
Are you a US Citizen?

Academic Information:
What is your major?
What is your reason for applying to the SSS program?
Do you receive ADA Accommodations? *

Family Information:
Parent 1's highest education level *
Parent 2's highest education level *
Have you completed FAFSA?
What financial aid are you currently receiving?

How Did Your Hear About the SSS Program?

By submitting this application, I authorize the SSS program to obtain, copy, review, and discuss records including (but not limited to): high school transcript, other college transcripts, financial aid records, standardized test scores, course registrations, academic progress, final grades and transcripts, and disability documentation. 

I authorize the use of my name and photograph to be published in SSS publications. I also certify the above information to be correct to the best of my knowledge.

I understand the completion of the application does not guarantee acceptance into the SSS program.

 

Provide Your E-Signature Below *
Please select a signature verification type.