Updated: 7/29/2015 The SSS TRIO program is 100% federally funded.
Original Hard File Yellow Mentor File
Student Support Services TRIO
Contact Preferences
Name: ID#:
Please rank how you would like SSS TRIO to communicate with you (i.e. 1, 2, 3, 4):
_____ Phone Message? Yes No Brief Detailed
Home Contact Info Verified
Cell Banner Heiberg
Text Yes No
_____Facebook
_____Email Address:_____________________________________________________
_____Mail Address:
Monday
Tuesday
Wednesday
Thursday
Friday
8:10-9:10
8:10-9:10
8:10-9:10
9:20-10:20
9:20-10:20
9:20-10:20
10:30-11:30
10:30-11:30
10:30-11:30
11:40-12:40
11:40-12:40
11:40-12:40
12:50-1:50
12:50-2:20
12:50-1:50
12:50-2:20
12:50-1:50
12:50-2:20
2:00-3:00
2:00-3:00
2:00-3:00
2:30-4:00
2:30-4:00
2:30-4:00
3:10-4:10
3:10-4:10
4:20-5:20
4:10-5:40
4:20-5:20
4:10-5:40
4:20-5:20
4:10-5:40
Online Only_____ Student Teaching_____
I understand that this information is to be used for purposes related to my education at Montana State
University Billings and my participation in the Student Support Services TRIO program.
Student’s Signature: Date: