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TRIO SSS Application

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TRIO Student Support Services Application

TRIO Support Services (SSS) is a federal program funded by a grant from the Department of Education. The purpose of TRIO-SSS is to support participants in achieving academic success. Students are accepted to the TRIO-SSS program based on academic need, eligibility criteria, and space availability. To determine your qualification for the program, please fill out the following application completely and accurately. The information you provide is strictly confidential. Completion of this application does not guarantee acceptance into TRIO-SSS.

"*" indicates required fields

Personal Information

Please enter your personal information.
Enter your 8-digit BSU student ID.
Name*
Address
Ethnic Origin*
Check all that apply
Citizenship*
Check only one.

Have you served in the U.S. military or reserves?
Have you completed the FAFSA?*

Educational Information

Please enter your educational information.
Which have you, or will you, receive:*
Month/Year
Month/Year
Did you earn any college credits while attending high school?
This would include any of the following: PSEO, College in the Classroom, IB, or AP
Have you attended college prior to attending Bemidji State University?
Anticipated start date at BSU*

Current College Level Status
Have you participated in any of the following TRIO programs in the past?*
Check all that apply

Eligibility Information (Part 1)

Please enter your eligibility information.
Did either of your parents earn a 4-year degree?*
Answer Yes if at least one of your parents received a diploma from a 4-year college or university. Answer No if your parent(s) attended a 4-year college or university but did not graduate. Answer No if your parent(s) received a diploma from a 2-year college.
Do you have a documented physical, psychological, or learning disability?*
Because you indicated you have a documented disability, you must either register with the BSU Accessibility Services Office or submit a signed document to the TRIO office from either your medical doctor, mental health counselor, or social worker stating that you have a physical or mental impairment that substantially limits one or more major life activities for you. Please indicate which you will do.

Eligibility Information (Part 2) - Income Verification

As a federally funded TRIO program, TRIO-SSS is required to provide documentation of your eligibility for our program to the U.S. Department of Education to meet TRIO regulations that two-thirds of the students in our program meet federal low-income guidelines. You must complete this section, whether or not you believe you qualify as low-income.
Did your parent(s)/guardian(s) claim you as a dependent on their Income Tax Form?*
Use either their 2023 or 2024 Income Tax form based on which year had the lowest taxable income.
For students whose parent(s)/guardian(s) claimed them on their Income Tax Form: Check the appropriate option to indicate if your parent(s)/guardian(s) taxable income is at or below the level listed for your parent(s)/guardian(s) family size.*
Size of Family Unit is the total number of dependents claimed on your parent(s)/guardian(s) Income Tax Form including the student applying to TRIO Student Support Services. You may use either 2023 or 2024 Taxable Income. Do not use gross income.
For students whose parent(s)/guardian(s) did NOT claim them on their Income Tax Form: Check the appropriate option to indicate if YOUR taxable income is at or below the level listed for YOUR family size.*
Size of Family Unit is the total number of dependents claimed on your Income Tax Form including yourself. You may use either your 2023 or 2024 Taxable Income. Do not use gross income.

Certification

I certify all information provided is true and correct to the best of my knowledge.
Name of Person Completing this Form*
Relationship to Applicant of Person Completing this Form*
MM slash DD slash YYYY

The contents of this form were developed under a grant from the US Department of Education. However, those contents do not necessarily represent the policy of the Department of Education, and you should not assume endorsement by the Federal Government.

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1500 Birchmont Drive NE
Bemidji MN 56601-2699

(218) 755-2001 | (800) 475-2001
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