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TRIO Student Support Services (SSS) provides mentorship and programming to first-generation, income-eligible, and students with a disability that helps foster an inclusive and resilient community.  We work with and empower each student as they navigate college and pursue their goal of earning a bachelor's degree.   

SSS is a 100% federally funded TRIO Program sponsored by the US Department of Education ($352,532 annually).  
General Information
Today's Date *
First Name *
Middle Name
Last Name *
CSS ID Number
Campus *
Address *
City *
State *
Zip *
Cell Phone Number *
CSS Email
Alternative Email address (if CSS email is unknown)

Personal Information
Date of Birth mm/dd/yyyy *
Gender *
Pronouns
Preferred Name (if different than listed above)
Major(s)
Minor(s)
Race/Ethnicity: (for below questions please select yes or no for each option) 
American Indian or Alaskan Native *
Asian *
Black or African American *
White *
Hawaiian or other Native to Pacific Island *
Hispanic *
Status
Are you a U.S. Citizen, National, or meet the requirements for federal student financial assistance? *
Are you pursuing your first bachelor's degree? *
Have either of your parents completed a four-year bachelor's degree? *
Do you have an impairment that limits one or more major life activities (e.g. physical or mental disability, ADHD, ADD, learning disability, chronic condition, mental health diagnosis, etc.)?
Have you ever participated in any TRIO program (Talent Search, Upward Bound, UB Math & Science, SSS, McNair, EOC) or AVID?

 

 

Step 2

In order for your application to be complete, please fill out the Income Verification Form.  Dependent students need a parent/guardian to fill out the form, Independent students can fill it out themselves.

 

 

Step 3: Sign and Submit Application

Upon Acceptance into the TRIO SSS program, the Participation Agreement States:

In order to remain eligible for TRIO SSS you must be an active participant and communicate regularly with our department.  This includes making and keeping appointments.  I understand the following services are provided by SSS including academic, personal, financial, and career goals.  Upon acceptance, students and assigned SSS  will discuss the full array of services available.  

I understand that TRIO SSS respects and upholds students' privacy and complies with FERPA.  SSS staff will only share student information with other college staff and faculty when that information is necessary to support student success.  I understand that SSS may work with Financial Aid and other college offices to verify and/or collect eligibility documentation. 

SSS staff are required to report suspicion of child or elder abuse, serious danger to self or others, and any information related to sexual and gender-based violence, harassment, and stalking.  We may also be required to share student information as required by court subpoena. 

TRIO SSS communicates with students using multiple modalities including email, google calendar, marketing platforms.  By signing below, you are giving TRIO SSS permission to connect with you using the program's standard communication methods.  *In accordance with the Privacy Act of 1974 (Public Law No. 93-579, 5 U.S.C. 552a), you are hereby notified that the Department of Education is authorized to collect information to implement the Student Support Services Program under Title IV of the Higher Education Act of 1965, as amended (Pub. Law 102-325, Sec. 402D).  In accordance with this authority, the Department receives and maintains personal information on tracking and evaluating participant progress.  Providing the information on this form is voluntary.  The information that is collected on this form will be retained in the program files and may be released to other Department officials in the performance of their duties.  

 

 

By using the signature pad below, you are agreeing to both the accuracy of application and the SSS Participation Agreement:
Student Signature *
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Signature: (Type in your full name)
I agree to the terms included.