Triumph and Surge Application

* =必填字段

学期* 2023年秋季

Student Cont行为 Information

名字*

M.I.

姓氏*

地址*

恰当的#

城市*

国家*

邮政编码*

Phone Number (Preferred for cont行为) *

Triton Email 地址*

Student Demographic Information

Triton Colleague ID *

出生日期*

种族认同*

What is your parental status? *

Self-identification is important, and we understand that we each have our own understanding of the words used to describe our own experiences. So that we can best honor your identity and experiences, please describe how you identify in the response box below AND select (as many as you want) from the list below.

In your own words, what is your gender identity?

Please share your pronouns

Select the pronouns you use, even if the same as above. 她/她/她的他/他/他的他们/他们/他们的泽/ Hir / Hirs 没有代词没有偏好未列出的拒绝回答

Student Education Information

就读高中 *

Colleges/Universities Attended *

First Generation Status Information

Does your Mother have a Bachelor's (4-year college) degree? *

Does your Father have a Bachelor's (4-year college) degree? *

Are you a PELL Grant recipient? *

Did you 应用 for FAFSA/R.I.S.E. 行为? *

Student Military Information

Serving 行为ive duty in the armed forces? *

Additional Information

What is your housing situation today? Check all that apply. * I have a steady place to live I have a place to live today, but I am worried about losing it I do not have a steady place to live 拒绝回答

What are your concerns about your housing situation? 勾选所有适用的. * 住房条件 Lack of permanent housing Ability to pay rent and/or utilities 安全的环境其他拒绝回答

Are you facing any food insecurities? *

Would you like to receive information regarding nutrition resources. (i.e., food banks/pantries, snap benefits) *

Do you have reliable transportation to and from 澳门赌博平台? If not, explain below. *

If you answered no to reliable transportation, please explain.

学生的反应

Please provide short responses to the following questions:

Why do you want to participate in this mentoring program? *

What do you hope to gain from joining 胜利与激荡? *

Please explain any scheduling issues that may prevent you from attending weekly workshops and meetings with your advisor/mentor. *

What are your hobbies/interests? *

学生验证

By signing this application, I attest that all the information on this application is true and accurate. I authorize the release and disclosure of official school records to 胜利与激荡; understanding that the information in these records will be used only to assess need for program services, including referral for financial assistance, but not limited to scholarships, federal financial aid, 工作研究, monitoring educational progress, evaluate the effectiveness of program 行为ivities, and fulfill program reporting requirements. I also allow 胜利与激荡 and 澳门赌博平台 to use my image for program promotional purposes.

Verification Confirmation *(represents electronic signature)

日期*(月/日/年)

Captcha is temporarily disabled.

字确认

An error has occurred while getting captcha image

在本节