SUNV
SCHENECTADY
COUNTY
COMMUN
I
TY
COLLEGE
~
Educational Opportunity
~
Program
___________________________________________________
Educational Opportunity Program Application
2020-2021
This form is required to complete your freshman application to the Educational Opportunity Program.
Please take time to complete all sections carefully and thoroughly. Once you have completed the
application, return it to the campus to which you are applying. Application deadline for the 2020-2021
academic year is July 17, 2020. All documents must be submitted by this date.
Part 1 Personal Information
Name: ________________________ _________________________ ___________________
(Last) (First) (Middle)
Gender: ___________________________ Date of Birth: ______/______/______
SUNY SCCC Student ID: __________________________________
Mailing Address: ___________________________________________________
Contact Phone: (______) _______________ Email Address:__________________________
Please mark one of the following ethnic identities:
__ Hispanic/Latino __ Not Hispanic/Latino
Please choose from one of the following racial identities. You may select more than one:
__ Asian
__ American Indian or Alaskan Native
__ Native Hawaiian or other Pacific Islander
__ Black or African American
__ White
Are you currently or have you ever been in foster care? Yes___ No___
Marital Status: Single __ Married __ Divorced __ Separated __ Widowed __
Are you a New York State resident? Yes ___ No ___
__________________________________________________________________________
If yes, how long? ________________years _______________months
Are you a United States citizen? Yes ___ No ___
If no, please provide your alien registration number______________________
Are you a veteran of the United States Armed Forces? Yes □ No □
Are you supporting a dependent? Yes ___ No ___
Part 2 Educational Information
Your intended academic major: _________________________________________________
Name of high school you graduated from or expect to graduate from:
High School GPA: __________
Expected date of HS graduation: ______/______/______
Type of Diploma: Regents □ Regents with advanced designation □ Local □ IEP (Individualized
Educational Program) □
If not a graduate of a New York State high school, did you receive a high school equivalency
diploma? Yes ___ No ___
If yes, provide the date: Month______ /Year______ Score: _____________
Part 3 Educational Goal
Please identify your educational goal as an EOP student:
___ I plan to complete a certificate program
___ I plan to graduate with an Associate’s Degree
___ I plan to transfer to a four-year college or university and pursue a Bachelor’s Degree
___ I am undecided at this time.
Part 4 _ Summer Program Requirement
Being part of EOP requires commitment to the program and to yourself! As a way to help you
better prepare for the rigors of higher education, you must attend a three (3) week summer
program, which will offer a rich college experience full academics and interactive activities. The
summer program is mandatory for all incoming students and is being offered July 20
th
- Aug 7
th
.
Will you be able to attend the summer program during these dates?
___ Yes, I am excited to attend and get ready for my academic future!
___ No, I will not be able to attend the summer program.*
*you are automatically disqualified from joining EOP. Please see staff for details.
______________________________________ ____________________
Part 5 Income Documentation Requirements
Income review is required to determine your eligibility into the EOP program. Please submit the
following documentation to the Financial Aid Office on campus, or via FASFA, as soon as
possible
- A signed photocopy of your parents’ 2018 Federal Tax Return (1040, 1040A, 1040EZ) or
an IRS return transcript.
- A signed photocopy of your 2018 Federal Tax Return (1040, 1040A, 1040EZ) or an IRS
tax return transcript.
- If a Federal Tax Return was not filed, we will accept your 2018 W2 form, 1099, form or
schedule C or CEZ.
- The 2020-2021 Verification (Dependent or Independent) Worksheet must be completed
(it is located on the SUNY SCCC website under Financial Aid/Verification).
- A letter form Social Security Administration showing amount of family benefits received
during 2018 or copies of all 1099 forms.
- A letter from Social Services showing all family benefits received during 2018 or a copy
of a current budget sheet.
- Documentation of child support received in 2018.
- Documentation of other non-taxable income received in 2018.
I hereby apply for services in the Education Opportunity Program (EOP) at SUNY Schenectady
County Community College (SUNY SCCC). I certify that the information I have supplied on this
form is true and accurate, to the best of my knowledge. I understand that EOP can share and
receive information from my educational benefit with other SUNY SCCC offices, staff and faculty
according to the Family Rights and Educational Privacy Act (FERPA) of 1974. I understand that
I may withdraw from this program at any time.
Signature Date
This completed form an all required documentation must be returned to:
SUNY Schenectady County Community College
Educational Opportunity Program (EOP) Office
78 Washington Avenue
Schenectady, NY 12305
Attention Jeff Aranda
You can also deliver in person to Jeff Aranda in Elston Hall room 221
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