TRIO Educational Talent Search Application



Directions: This application should be completed by a parent/legal guardian. Applications are only considered complete when all questions on this application have been completed and this form has been signed by both the parent/legal guardian and the student applicant. Please note that questions regarding an applicant’s race, ethnicity or language are purely for statistical tracking required by the U.S. Department of Education, and are not considered when determining an applicant’s eligibility for services. By signing this document you verify the truth and accuracy of the information provided. To expedite the processing of your application you may also submit this form with a copy of your most recent transcript. ________________________________________________________________________________
A. STUDENT INFORMATION
First Name *
Last Name *
Gender * Male Female
Date of Birth *
Current Age *
Current School * George Washington HS John F. Kennedy HS Okkodo HS Simon Sanchez HS Vicente Benavente MS Tiyan HS Guahan Academy Charter School St. Paul Christian School Astumbo MS Agueda I. Johnston MS Luis P. Untalan MS Academy Of Our Lady F.B. Leon Guerrero MS Notre Dame High School Oceanview Middle School Other - Re-Entry Guam HS Harvest Christian Academy Southern HS JP Torres Alternative School Home School Father Duenas MS SIFA Inarajan Middle School St. Anthony Catholic School Majesty Christian Academy St. Johns School Career Tech High Academy Charter School Bishop Baumgartner Memorial Catholic School Asmuyao Community School Business & Technology Academy Charter School
Current Grade Level * 6th grade 7th grade 8th grade Freshman in high school or in alternative education organized by grade (Grade 9 only) Sophomore in high school or in alternative education organized by grade (Grade 10 only) Junior in high school or in alternative education organized by grade (Grade 11 only) Senior in high school or in alternative education organized by grade (Grade 12 only) Student in high school equivalency program, or in alternative education not organized by grade Students in 4th year of high school in a five-year dual enrollment program Students in 5th year of high school in a five-year dual enrollment program Secondary school dropout Other participants Unknown
How did you hear about the ETS Program? Counselor School Presentation Info Booth Friend or Family
Are you enrolled in TRIO Upward Bound Program? * Yes No
Ethnicity * Hispanic/Latino of any race Am. Indian or Alaska Native, non-Hispanic/Latino Asian, non-Hispanic/Latino Black or African American, non-Hispanic/Latino White, non-Hispanic/Latino Nat. Hawaiian or Other Pac Islndr, non-Hisp/Latino Two or more races, non-Hispanic/Latino Race or Ethnicity Unknown
Are you enrolled in LOTE Courses? * Yes No
If Yes, what is your native language
Citizenship * United States Citizen, national, or permanent resident Citizen/resident of the Republic of Palau Citizen/resident of FSM (Pohnpei, Chuck, Yap, or Kosrae) Citizen/resident of the Republic of the Marshall Islands
If you are a U.S. Permanent Resident (Green Card Holder) please provide Alien Registration Number
Full Mailing Address (Address, City, State, Zip Code, and Country):
Student's Mobile Phone *
GDOE Email *
Personal Email *
________________________________________________________________________________
B.PARENT/LEGAL GUARDIAN INFORMATION AND INCOME VERIFICATION
The student applicant regularly resides with and receives support from * Both Parents (Mother & Father) Mother Only Father Only Step Parents Legal Guardians Grandparents Foster Parents Other
If other, please specify
Mother/Legal Guardian Name *
Highest Education Completed * High School Diploma/GED or Lower Associate's Degree (2-year College Degree) Bachelor's Degree (4-year College Degree or more)
Mobile Number *
Work Number *
Email Address *
Father/Legal Guardian Name *
Highest Education Completed * High School Diploma/GED or Lower Associate’s Degree (2 year College Degree) Bachelor’s Degree (4-year College Degree or more )
Mobile Number *
Work Number *
Email Address *
How many people are in your household, including yourself? *
Did you file your 2023 taxes? * Yes, I will provide my taxable income No, please provide your total 2023 income. If no income earned put zero (0)
If you put YES, please provide taxable income (1040 line 15) *
If you put NO, please provide total earnings (Gross Income) for the previous tax year (If no income was earned, put zero)
What was your source of income? *
Do you currently receive any public assistance for low/no-income households? No Yes, Specify
SNAP (Food Stamps)
Medicaid
Section 8
Other
If other, please specify
________________________________________________________________________________
C. AUTHORIZATION & RELEASE
I grant my son/daughter permission to participate in Talent Search-sponsored activities and field trips. I understand that my son/daughter is expected to obey all rules and regulations of the Talent Search program. I also understand that failure to obey written or verbal rules and regulations will be sufficient reason to terminate my child's participation in Talent Search activities or field trips by sending them home. I hereby release and forever discharge University of Guam and its staff members from all manner of claims and responsibilities due to any risks encountered by my son/daughter. I hereby authorize the UOG Talent Search Program to have access to my child’s permanent school records during the application process and throughout the period of their participation in the program. I also give permission for the use of my child’s name and /or photograph for editorial, promotional, recruitment or educational purposes. PLEASE WAIT FOR YOUR SIGNATURE TO BE ACCEPTED BEFORE MOVING ON.
Photography & Media Publication: * ALLOW my child photography publication OPT-OUT my child of photography publication
Student Applicant Signature * Signature Type: Simple Start Over Signature: (Type in your full name) I agree to the terms included.
Parent/Legal Guardian Signature * Signature Type: Simple Start Over Signature: (Type in your full name) I agree to the terms included.
________________________________________________________________________________
D. STUDENT COMMITMENT
Attend school regularly, refrain from discipline/behavioral problems and strive to earn high grades in all classes. Contact my ETS Advisor if there is a change in my class schedule, my home address or phone number, and/or if my family plans to move. Seek help with academic or personal problems, if needed. Take advantage of special program activities such as college visits, financial aid workshops, and cultural events. Successfully be promoted to the next grade each year in the program. Apply for financial aid during my senior year. Graduate from high school and enroll in a post-secondary education institution after graduation. PLEASE WAIT FOR YOUR SIGNATURE TO BE ACCEPTED BEFORE MOVING ON
Student Applicant Signature * Signature Type: Simple Start Over Signature: (Type in your full name) I agree to the terms included.
________________________________________________________________________________
E.STUDENT EDUCATION FORM
What are your plans after high school?
Military
Work
2-Year College
4-Year College/University
Trade/Training Program
Unsure
Are you considering off-island colleges/universities? * No Yes
Where are you interested in going to college?
University of Guam
Guam Community College
Undecided
Off-island, please specify:
What are your career interests? Please specify: *
Are you currently working? * Yes No
If yes, how many hours per week? *
Have you taken the ACT or SAT? * Yes No
ACT Test Score, if none put N/A: *
SAT Test Score, if none put N/A: *
Are you taking any AP Classes? * Yes No
If yes, please specify AP Classes, if not taking AP Classes put N/A: *
What grades do you earn most of the time in school? * A A-B B B-C C C-D D D-F
What information or assistance is most helpful to you (Choose from Academic Support, College Preparation, Tutoring, or all that apply): Academic Support (Specify below):
Improving Study Skills
High School Course Selection
Confidence Building
Goal Setting Skill
Improving Test Taking Skills
Social and Emotional Learning Skills
College Preparation (Specify below):
College Information & Readiness
Information on applying/receiving scholarships
Information on paying for college
Information on FAFSA
Choosing a college major and career
Getting ready for the (PSAT, SAT, & ACT)
College tours and visits
Information on Career Interest & Readiness
Tutoring (Specify Subject(s)) Put N/A if none: *
________________________________________________________________________________
F. SUBMISSION Make sure to complete the required fields before submitting the application form. Once it has been sent, ETS will review and process your application. ETS will also call you for additional information if there are missing information. If you have met the program criteria, an ETS staff will be contacting you and you will also be sent an acceptance letter to the program. If you may have additional questions, feel free to send us an email at trioets@triton.uog.edu, Whatsapp or contact us at 735-2246. Have a wonderful day and stay safe! TO ENSURE YOUR APPLICATION HAS BEEN SUBMITTED, PLEASE WAIT FOR YOUR SUBMISSION TO BE ACCEPTED BEFORE EXITING THE WINDOW.