Impact Programs at Aims
SSS-Classic * SSS-STEM * CORE Application
Enrollment: (check one)
I have applied to Aims but am not in classes I plan to begin classes Fall 20___ Spring 20___ Summer 20___
I am currently taking classes at Aims
I am returning to Aims
I transferred to Aims
Have you applied for financial aid at Aims? Yes No
If you have applied, are you receiving aid this semester? Yes No
What types of financial aid are you receiving _____________________________________________________________
If you did not apply for financial aid this semester, please explain why: ________________________________________
Name of High School: ___________________________________________ Graduation Date: _____________________
Date Received GED: ___________________________________________________
I plan to earn an Associate degree from Aims Yes No Intended Major/Career Path: ______________________
I plan to transfer to a 4-year college/university Yes No Institution: ____________________________________
What types of services would be beneficial to you?
Academic Advising Career Planning Tutoring Workshops Mentoring
Financial Aid Advising Transfer Advising Financial Literacy Leadership Opportunities
Have you been a TRIO Program participant previously?
Education Opportunity Center (EOC) McNair Educational Talent Search (TS)
Upward Bound (UB) Upward Bound-Math Science (UB – MS)
Veterans Upward Bound (VUB) Student Support Services (SSS)
How were you referred to the TRIO & CORE Impact programs: ______________________________________________
TRIO Impact Programs provide individualized services addressing specific needs of students as they confront the challenges
of completing a college certificate or degree. I certify, under penalty of perjury, that the information I have provided on this
form is true and complete without evasion or misrepresentation. I understand that if found otherwise, it is sufficient cause
for dismissal from the TRIO & CORE Impact Programs. If asked by an authorized official, I agree to provide proof of the
information I have provided.
I understand TRIO & CORE staff at Aims will utilize the information provided to assess my academic, career, and financial
aid planning needs. I understand this information will be used in strictest confidence. I give my permission to release
information that will assist TRIO & CORE staff in ongoing evaluation of my academic pursuits. I acknowledge that TRIO
& CORE staff will assist me in achieving my academic goals only if I fulfill my obligations as agreed upon by TRIO &
CORE staff and myself.
By signing this form, I acknowledge and understand that the TRIO SSS programs are federal grant-funded programs from
the U.S. Department of Education and services provided to me are contingent on continuation of funding. I understand that
the level of TRIO & CORE services may change due to changes in funding.
Student Signature: ___________________________________________ Date: __________________________________
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