Fillable STUDENT REFERRAL FORM (Southern University at Shreveport)

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STUDENT REFERRAL FORM (Southern University at Shreveport)

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TRIO STUDENT SUPPORT SERVICES
STUDENT REFERRAL FORM
Southern University at Shreveport’s TRiO Student Support Services (SSS) program
is designed to assist first-generation, low-income, and/or students with disabilities
toward the successful completion of their postsecondary education. SSS empowers
scholars to develop the necessary skills, knowledge and attributes to reach their
full academic potential.
If you know a student currently enrolled at SUSLA who is interested in the TRiO Student
Support Services program, or know a student that can benefit from SSS services,
please use this form to provide us their information. SSS services include academic
advisement, transfer and graduation assistance, tutorial services, financial
literacy, success workshops, cultural enrichment activities, technology access, and
grant aid. The SSS staff will contact the student and assess their potential eligibility. If
you have more than one student, please complete a referral for each student.
Your name (first, last)
Your email address
Your classification
Faculty Staff Other
How do you know the student you are referring?
Student Name (first, last)
Student email
Student Contact Number (if known)
( )
Is the student aware of your referral?
Yes No
Student’s Major (if known)
How do you think the student will benefit from being a part of the SSS program?
Thank you!
Click the "Submit" button to send to SSS
SSS/sg_12021
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STUDENT REFERRAL FORM (Southern University at Shreveport)

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Completed 3 February 2021

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