Fillable EDUCATIONAL TALENT SEARCH PROGRAM Southeastern Community College (Southeastern Community College)

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EDUCATIONAL TALENT SEARCH PROGRAM Southeastern Community College (Southeastern Community College)

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The EDUCATIONAL TALENT SEARCH PROGRAM Southeastern Community College (Southeastern Community College) form is 2 pages long and contains:

  • 2 signatures
  • 53 check-boxes
  • 44 other fields

Country of origin: US
File type: PDF

U.S.A. forms for Southeastern Community College

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EDUCATIONAL TALENT SEARCH PROGRAM
Southeastern Community College
A
pplication Release Form
2020-2021 School Year
Please print and fill out completely.
Date:
Grade:
School:
First Name
Middle Name
Last Name
Home Phone
Address
Cell Phone
City/State
Zip Code
Student email
Parent e-mail
Birth Date
Social Security No: (required)
Gender
Male
☐
Female
US Citizen
☐
Yes
☐
No
Race
☐
African American/Black
☐
Asian/Pacific
Islander
☐
Caucasian/White
☐
Hispanic
☐
Native American
☐ Multiracial
☐ Other (specify) ________________________________
With whom do you live?
☐
Both Parents
☐
One Parent
☐
Parent and
Stepparent
☐
Adoptive
Parent(s)
☐
Grandparents
☐
Foster Parents
☐
Other (specify)
Father/Guardian Name
Job
Mother/Guardian Name
Job
Did either parent graduate from a 4-year college?
☐
Yes
☐
No
College Name
Parent or Guardian must complete
Check the box that indicates family taxable income (after deduction):
☐
$18,735 or below
☐
$18,736 – 25,365
☐
$25,366– 31,995
☐
$31,996 – 38,625
☐
$38,626 - 45,255
☐
$45,256 – 51,885
☐
$51,886 - 58,515
☐
$58,516 - 65,145
☐
$65,146or above
Check any of the following from which you receive assistance:
☐
School Lunch
☐
Social Security
☐
AFDC
☐
Disability
☐
Food Stamps
☐
Medicaid
☐
Other (specify) ________________________________________
Total number living in household: _________
PERMISSION FOR ACCESS TO EDUCATIONAL RECORDS
I hereby give permission for the Educational Talent Search Program to have access to any educational records which
are needed for full program services. I also give permission to the postsecondary institution I attend to release
admission and financial award information to the SCC Educational Talent Search Program. I grant SCC permission
to reprint my child's photograph for publication, website, electronic and digital media, publicity, and advertising.
Date
Student Signature
Date
Parent/Guardian Signature
click to sign
signature
click to edit
click to sign
signature
click to edit
EDUCATIONAL TALENT SEARCH PROGRAM
Southeastern Community College
Application Release Form
2020-2021 School Year
Individual Education Plan
EXPECTED GRADUATION DATE: ___________________________
What are your plans after high school? Checkbox
Four-year college
Community College
Get a job
Join Military
Undecided
Other
What colleges are you interested in attending? 3 fill-in options
1. ________________________________
2. ________________________________
3. ________________________________
What college campuses have you visited? 3 fill-in options
1. ________________________________
2. ________________________________
3. ________________________________
In what extra-curricular activities have you participated?
Have you taken the SAT?
☐Yes
☐No
If yes, what was your composite score?
Score:
Do you plan to take the SAT?
☐Yes
☐No
Have you taken the ACT?
☐Yes
☐No
If yes, what was your composite score?
Score:
Do you plan to take the ACT?
☐Yes
☐No
What are your hobbies?
What are your favorite subjects?
Please list any subject(s) in which you are experiencing trouble/poor grades.
Educational Talent Search Program offers the following services:
(Please check any you need help with)
☐ Career Information
☐ College Information/Tours
☐ Financial Aid Information
☐ Scholarship Information
☐ Academic/Career Counseling
☐ Tutoring (List Subject)
☐ College Application Assistance
☐ Financial Aid Application Assistance
☐ Personal Counseling
☐ Study Skills Information
☐ Other (specify)
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EDUCATIONAL TALENT SEARCH PROGRAM Southeastern Community College (Southeastern Community College)

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Completed 25 July 2020

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