TRIO SSS Application | Sonoma State University



Thank you for your interest in TRIO Student Support Services at Sonoma State University! Please complete this application as thoroughly as possible. You cannot save and restart this application. Questions about this application? Contact Senai Embaye, TRIO Administrative Analyst at embayes@sonoma.edu.

General Information:
School ID *
First Name *
Last Name *
Email Address *
Have you already earned a Bachelor's degree? * Yes No
Are you a current or incoming student? * Current SSU Student Incoming Student
What is your Major? * American Multicultural Studies Anthropology Applied Statistics Art Studio Biochemistry Biology Business Administration Chemistry Chicano & Latino Studies Communication Studies Computer Science Criminology & Criminal Justice Early Childhood Studies Earth Science Economics Electrical Engineering English Environmental Studies Geography Geography & Environment Geology Global Studies History Human Development Kinesiology Liberal Studies Hutchins Liberal Studies Napa Mathematics Modern Languages Music Nursing Philosophy Physics Political Science Pre-Business Administration Pre-Nursing Psychology Sociology Spanish Spanish Statistics Theatre Arts & Dance Undeclared Women's & Gender Studies

Demographic Information
Gender * Male Female
Hispanic or Latino * No Yes
Please indicate yes to one or more Races that apply to you among the following (as defined by the U.S. Department of Education): Note: An individual whose ethnicity is reported as “Latino or Hispanic” should also report one or more racial classifications. American Indian or Alaska Native - American Indian/Alaskan Native refers to a person having origins in any of the original peoples of North and South America (including Central America), and who maintains tribal affiliation or community attachment. Asian - A person having origins in any of the original peoples of the Far East, Southeast Asia, and the Indian subcontinent. This area includes, for example, China, India, Japan, Korea, and the Philippine Islands. Black or African American - A person having origins in any of the black racial groups of Africa. Native Hawaiian or Other Pacific Islander – A person having origins in any of the original peoples of Hawaii or other Pacific islands such as Samoa and Guam. White - A person having origins in any of the original peoples of Europe, North Africa, or the Middle East.
Are you American Indian or Alaska Native? * Yes No
Are you Asian? * Yes No
Are you Black or African-American? * Yes No
Are you Native Hawaiian or other Pacific Islander? * Yes No
Are you White? * Yes No

TRIO SSS Eligibility Information:
Do either of your parents (biological or adoptive) have a Bachelor's degree? * Yes No
Are you a student with a disability? (optional) Yes No
Are you registered with SSU's Disability Services for Students (DSS)? (optional) Yes No
Income Eligibility: Please complete the appropriate Independent OR Dependent Student Income Eligibility Verification Form, linked below. *Your a*pplication will not be reviewed until your completed Income Eligibility form is submitted. How do I know if I am an Independent or Dependent student? Independent Students Dependent Students Instructions: Dependent Students - start by filling out your Full Name, SSU ID, and SSU Email. Then click Submit. You will be prompted to enter Parent/Guardian's Name and Email. The form will be sent to them to complete and sign. Independent Students - complete the full form yourself. Note: For the number of dependants, please make sure to count yourself as well as your dependants.

Other Information:
Are you working? No Yes: Full-time Yes: Part-time
Are you a parent? * No Yes
Are you a current or former foster youth? * Yes No
Have you completed your FAFSA for the upcoming academic year? * No Yes Not Applicable
Are you a Veteran or a child of a Veteran? * No Yes
How did you hear about us? * Advisor Digital Ad DSS Email EOP Peer Coach Faculty/Staff Flyer or mailer Friend Campus event Seawolf Scholars Social Media TRIO Website Other
Other

Self-Identified Needs: Please check any areas in which you may need assistance:
Academic Advising
Major/Career Guidance
Stress/Time Management
Math/Science Tutoring
Study/Note Taking Skills
Financial Aid Guidance
Writing Tutoring
Graduate School Guidance
What additional support would help you succeed?

By signing below, I affirm, under penalty of perjury, that all information provided in this application and the accompanying Income Verification Form is true, complete, and accurate to the best of my knowledge. If asked by an authorized official, I agree to provide proof of this information, which may include a copy of my and my parent's/spouse/registered domestic partner's income tax return(s). I acknowledge that any false statement or failure to give proof when asked may be caused for denial or withdrawal from the program.
* Signature Type: Simple Start Over Reset Signature Pad Click here to start signing. Tool Dialog Close Pencil Reset Signature: (Type in your full name) I agree to the terms included.
Privacy Statement: The information that you provide to TRIO Student Support Services is retained in the program office and is protected by the Federal Family Education Right and Privacy Act (FERPA). Only authorized personnel will see this information. The U.S. Department of Education has the authority to gather the information in order to determine eligibility for the program and to evaluate the success of the program services.