PY19/20 Application
5401 West 20
Street, Greeley, CO 80632 | College Center 220 970-339-6372
Please return completed application to the TRIO SSS office in College Center 220. Incomplete applications will not be processed! Applications take a
minimum of two weeks to process. Once eligibility is determined a letter will be sent to your Aims email. If you have any questions, please contact the
TRIO SSS office at 970-378-3627 or e-mail
. Please print in ink!
Date: ____________________________ Aims #:A00_____________________________________
Name: _________________________________________________________________________________________________________________
Last First M.I.
Address: _______________________________________________________________________________________________________________
Street City State Zip
Home Phone: _____________________________________ Cell Phone: _____________________________________________
Aims E-mail: Future Career Title: _____________________________________
Date of Birth: ___________________________ Gender: Male Female
Education: High School Diploma GED Graduation Date: ________________________________________
How were you referred to TRIO SSS? Education Opportunity Center (EOC) Upward Bound (UB)
Educational Talent Search (TS) Student Support Services (SSS) Gear-Up
Avid Other: _______________________________________________________________________________________________
*If you identify as an undocumented immigrant, you do not meet eligibility requirements for TRIO SSS, however, we would like to refer you to the
Aims Center for Diversity and Inclusion (CDE), Ed Beaty, Rm. 127 for additional resources.
What is your citizenship status? : US Citizen US Permanent Resident
Did either of your parents, or legal guardians, complete a Bachelor’s Degree Yes No
Do you have a documented disability? Yes No
If yes, have you submitted documentation to the Disability Access Center? Yes No
Have you obtained a previous degree/certificate from any College/University? Yes No
Institution: ________________________________________________________
Are you Hispanic/Latino? Yes No
Race (Must check one) American Indian/Alaskan Native Asian Black or African American
Native Hawaiian/Pacific Islander White
If your status is Independent, answer the following income questions about yourself and your dependents. If your status is Dependent, your parents
must answer the following questions about themselves and their dependents. Please select only ONE option.
I am an independent. (1) I am married or (2) I am 24 or older by December 31 of 2019 or (3) have served in the military or (4) I have a child
that I support more than 50% of the time or (5) I was in Foster Care at the age of 13 or older.
I am a dependent. (1) I am not a parent, and (2) I am not married, and (3) I am under the age of 24, and (4) I have not served in the military
Did you and/or your parents file income taxes last year? Yes No
Number of people in your household (please include yourself):___________________
Taxable Income (not adjusted gross income or “annual salary”): ____________________
Depending on which tax form was filed, you will find the amount of your taxable income on: 1040-line 10.
Dependent Students Only
Parent or Legal Guardian Signature: ___________________________________________ Date: __________________________________
click to sign
click to edit
PY19/20 Application
5401 West 20
Street, Greeley, CO 80632 | College Center 220 970-339-6372
Have you applied for financial aid (FAFSA) at Aims? Yes No
If you have applied, are you receiving aid this semester? Yes No
What types of financial aid are you receiving? (Check all that apply) Loans Scholarships Grants
If you did not apply for financial aid this semester, please explain why: ___________________________________________________________
I plan to earn an Associate degree from Aims I plan to transfer to a 4-year college/university
Yes No Yes No
Intended Major/Career Path: ___________________________ Institution: ___________________________
1. Please describe your academic and career goals.
2. The TRIO SSS programs has high expectations for commitment and participation and programs and services. How will you
demonstrate your commitment to the TRIO SSS program during your academic journey at Aims? Please give an example of how you
have shown your commitment to another program in which you participated.
3. What do you hope to gain from your participation in TRIO SSS?
By signing this application, you agree to participate in the TRIO SSS program and give your permission to the program staff to access your
academic records to verify your eligibility for program services. Furthermore, you understand that as a TRIO SSS participant you must
remain committed to meeting with your TRIO SSS advisor on a regular basis throughout your entire Aims academic career and will actively
participate in all required programs and services offered to you as a program participant. Also keep in mind that the program staff adhere
to all guidelines outlined under the Federal Education Rights and Privacy Act (FERPA).
By signing this form, I give permission to Aims Community College Office of Financial Aid to release information regarding my financial aid
awards and student account information to the TRIO SSS Programs. I understand that this authorization will be effective until I revoke it in
Federal regulations govern the funding granted to Aims to host the TRIO SSS Programs. Accurate response to all the questions, including
family size and income and parental educational attainment ensure that the programs are operating by mandated federal regulations. I certify
that the information submitted in this application is complete and accurate to the best of my knowledge.
Student Signature: ___________________________________________ Date: __________________________________
click to sign
click to edit