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College of the Desert TRiO Veterans Services (College of the Desert)

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U.S.A. forms for College of the Desert

BROWSE COLLEGE OF THE DESERT FORMS

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College of the Desert
TRiO Veterans Services
The TRiO Veterans Program at College of the Desert is a counseling program designed to assist students
in meeting the challenges of graduating from COD or/and transferring to a four-year university of their
choice. The program is a Student Support Services (SSS) Program under the U.S. Department of
Education’s TRiO Programs.
TRiO Veterans Services Students Benefit From:
Counseling: All participants receive assistance
from their assigned counselor in preparing a
COD Student Educational Plan (SEP), selecting
the appropriate major, associate degree,
certificate and transfer courses,
applying for financial aid, and developing
career goals. These individualized counseling
services are available until student veterans
graduate and transfer from COD.
Graduation & Transfer Assistance: Students
are assisted with selecting the appropriate
courses necessary to receive an associate degree
or a certificate from COD and to transfer to a
four-year university.
Financial Literacy and Scholarship
Assistance:
All students will receive financial
and economic literacy counseling services to
include financial planning for postsecondary
education. Students are provided information on
Federal student financial aid programs and
benefits and resources for locating public and
private scholarships. In addition, participants are
also assisted with completing the application
(FAFSA) for financial aid and scholarships for
their COD enrollment and for their transfer
universities and or colleges.
Cultural Events & College Tours: Participants
are offered opportunities to attend various local
and regional academic and cultural events, such as
college tours and museum visits.
Priority Registration:
As veterans, students in
the program retain their priority one status and
register for classes on the 1st priority date
assigned for class registration.
Workshops: College Success, Study Skills and
Student Development Workshops help students
develop and enhance important skills allowing
them to achieve and successfully accomplish
their academic goals.
Free Tutoring:
Free one-on-one and tutoring
assistance in most subjects is made available
to all students in both the TRiO Veterans office
and the Tutoring & Academic Skills Center.
Computer Support & Lab: Participants have
access to desktop computers and printers.
Laptop computers (with internet and some with
WiFi) are also available exclusively to TRiO
Vets students to use in the computer lab.
Calculator Loans: Scientific calculators are
available to students to check out for the
semester.
TRiO Grants (pending funding): Grants are
available for TRiO Veterans students who
are active participants, in good academic
standing, who receive a Pell grant, and have
substantial unmet financial need.
PLEASE NOTE: THE TRIO VETERANS APPLICATION IS A PROTECTED DOCUMENT AND YOU WILL NEED TO PRINT AND SCAN IF YOU WANT TO SAVE A COPY FOR YOUR PERSONAL RECORDS
Size of Family
Unit
Yearly
Taxable Income
1
18,210
2
24,690
3
31,170
4
37,650
5
44,130
6
50,610
7
57,090
8
63,570
U.S. Dept. of Human & Health Services,
January 2018 (Guideline changes annually)
Eligibility and Selection Criteria
* You do not have to meet all of the following requirements
• Military status: All participants must be veterans or reservists. All discharges must be
under conditions other than dishonorable.
• Financial Need: Applicants must meet federally established income guidelines (see
table below).
• First Generation College Student: Both applicants’ parents do not have a bachelor’s
degree.
• Academic Need: An applicant’s COD assessment scores are used for placement in the
appropriate English or Math courses.
• Plan to Graduate and Transfer: Applicants must earn an associate degree or certificate
AND declare a plan to transfer to a four year college or university.
• Academic Standing: Applicants who have completed 24-30 transferable course units
will be given preference for admission into the program.
• Residency Status: Applicants must be a US citizen or a permanent resident of the U.S.
Minimum Federal Income requirements for TRiO Veterans Services
Your family income must fall at or below the following standards:
How to Apply
Submit a completed application and supporting income verification documentation (i.e.
your IRS tax forms or the Income Statement Form in the back of this application, disability
and /or proof of independent status) to:
Craig Doussett
TRiO Veterans Services
South Annex 10
College of the Desert, 43-500 Monterey Avenue, Palm Desert, CA 92260
For any questions pertaining to the program, please email or call
Craig Doussett 760-862-1398 –
crdoussett@collegeofthedesert.edu Revised 10/10/18- DD
PLEASE NOTE: THE TRIO VETERANS APPLICATION IS A PROTECTED DOCUMENT AND YOU WILL NEED TO PRINT AND SCAN IF YOU WANT TO SAVE A COPY FOR YOUR PERSONAL RECORDS
TRiO Veterans Services
Application
Students who wish to participate in the program must complete this application, provide supplemental information where
necessary and answer the questions listed on the back. The information you provide is strictly confidential.
PERSONAL INFORMATION
1a: LAST FOUR DIGITS OF
SSN #
1b. COD STUDENT ID
#:
FEMALE
3. DATE OF BIRTH:
/ /
4. NAME: FIRST
LAST:
5. MAILING ADDRESS
CITY
STATE
ZIP CODE
6. CELL PHONE #:
7. DAYTIME PHONE #:
8. BEST EMAIL ADDRESS
This is how we’ll contact you
9. EMERGENCY CONTACT:
(Name, Phone, Relationship)
ELIGIBILITY CRITERIA
1. CHECK ONE: a. U.S. CITIZEN: ________ b. PERMANENT U.S. RESIDENT: ________ IF PERMANENT RESIDENT:
Resident Card #:_____________________
2. ANNUAL FAMILY TAXABLE INCOME:
(As listed on 1040 Income Tax Form) $
3. NUMBER OF FAMILY MEMBERS LIVING AT HOME:
(As listed on 1040 Income Tax Form)
4. DID YOU APPLY FOR FINANCIAL AID? YES____ NO____
5. DID YOU RECEIVE A PELL GRANT? YES____ NO____
6. DOES YOUR FATHER HAVE A: BACHELOR’S DEGREE (4 yrs): YES____ NO____ YEAR OF GRADUATION:
6a. DOES YOUR MOTHER HAVE A: BACHELOR’S DEGREE (4 yrs): YES____ NO____ YEAR OF GRADUATION:
7. DO YOU HAVE A V.A DISABILITY RATING? YES____ NO____
ETHNICITY
1. AMERICAN INDIAN OR ALASKAN NATIVE _____ 2. ASIAN AMERICAN OR ASIAN _____ 3. BLACK OR
AFRICAN-AMERICAN _____
4. HISPANIC or LATINO _____ 5. CAUCASIAN (WHITE) _______ 6. NATIVE HAWAIIAN OR OTHER PACIFIC
ISLANDER ______
OTHER INFORMATION
COD OBJECTIVE (INFORMED GOAL)
ASSOCIATE (A.A./A.S.) DEGREE ONLY_____ TRANSFER ONLY _____ ASSOC. DEGREE & TRANSFER _____
MAJOR:
MINOR:
2. ARE THERE OTHER PROGRAMS IN WHICH YOU ARE ENROLLED AT COLLEGE OF THE DESERT? (check all that apply).
EOPS ___ CARE___ DSPS____ MESA ___ OTHER _________________
3. ARE YOU CURRENTLY IN THE RESERVES? YES_____ or NO_______
PLEASE COMPLETE REVERSE SIDE OF PAGE
OFFICE USE ONLY
APPLICATION
RECEIVED DATE:
APPOINTMENT DATE:
DATE ENTERED:
DATE ENTERED COD:
COUNSELOR:
PRIORITY:
ACADEMIC LEVEL:
Freshman
Sophomore
Date entered in STAL:
COD PRIORITY:
ELIGIBILITY: 1: LI&FG – Low Inc. /First Gen. ACADEMIC NEED:
2: LI – Low Income 1: Assessment/Diagnostic tests
3: FG - First Generation 2: Lack of educational and/or
4: DL – Disab
led/ Low-Income career goals
5: D – Disabled 3: Lack of acad. preparedness
COLLEGE UNITS
COMPLETED: ________ CUM GPA: _________
CURRENT UNITS: TRANSFERRABLE UNITS:
Financial Aid Need:
Financial Aid Unmet Need:
Financial Aid Awarded:
Type:
PLEASE NOTE: THE TRIO VETERANS APPLICATION IS A PROTECTED DOCUMENT AND YOU WILL NEED TO PRINT AND SCAN IF YOU WANT TO SAVE A COPY FOR YOUR PERSONAL RECORDS
TRiO Veterans Services Application Personal Questionnaire
PLEASE ANSWER EACH OF THE FOLLOWING QUESTIONS
1. How did you hear about the TRiO Veterans Program? (please write name if personal
referral)
2. Why are you interested in becoming a participant in the TRiO Veterans Program?
3. What are your educational and career goals?
4. Please state your (previous) rank, military branch, and how long you served?
By enrolling and participating in the TRiO SSS Veterans Services at the College of the Desert, I give my permission to the program staff to access
my COD records (including those at the Financial Aid and Admissions and Records offices) for the purposes of determining program eligibility. By
signing below, I verify that the information I have submitted on my application is true and complete to the best of my knowledge. Failure to provide
necessary documentation may be cause for denial and/or cancellation in the Program. I also give the program permission to verify the information
on my application as necessary and to monitor my academic progress while enrolled at COD.
**Privacy A
ct: In accordance with the Privacy Act of 1974 (Public Law No. 93-579,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 participants in the Student Support Services program. The principal purpose for collecting this information is to administer the program,
including tracking and evaluating participant progress. Providing the information on this form, including a social security number (SSN) is
voluntary; failure to disclose a SSN will not result in the denial of any right, benefit or privilege to which the participant is entitled. 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
official duties.
Student Signature______________________________________ Date_____________________
SSS Veterans Services is a federally funded TRiO Student Support Services Program
Revised 10/10/18 DD
PLEASE NOTE: THE TRIO VETERANS APPLICATION IS A PROTECTED DOCUMENT AND YOU WILL NEED TO PRINT AND SCAN IF YOU WANT TO SAVE A COPY FOR YOUR PERSONAL RECORDS
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Income Statement (OPTIONAL)
If you have not filed and/or will not file or do not have access to your U. S. Income Tax
return (1040, 1040A, 1040EZ, etc.) for the most recent required filing period, please list all
household income you and your spouse received which would have been reported on that
return. This information will be used to calculate your taxable income for the purpose of
establishing eligibility to participate in the program.
Sources of Income Yearly Amount Taxable Y/N
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
Size of Family/ (include yourself). _________
Filing status: Single Married/Filing Jointly Married/Filing
Separately
Head of Household Qualifying Widow(er) with Dependent Child
All information on this form is true and complete to the best of my knowledge.
Print Name _______________________________________
Signature ___________________________________Date: ______________________
PLEASE NOTE: THE TRIO VETERANS APPLICATION IS A PROTECTED DOCUMENT AND YOU WILL NEED TO PRINT AND SCAN IF YOU WANT TO SAVE A COPY FOR YOUR PERSONAL RECORDS
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College of the Desert TRiO Veterans Services (College of the Desert)

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Completed 25 July 2020

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