TRiO Application "*" indicates required fields The Student Support Services (SSS) Program at Frank Phillips College, Borger campus, is a federally funded TRiO Program designed to ensure the success of students who may face obstacles or are considered to be at high risk of not completing their college education. Our mission is achieved through peer and faculty mentoring, academic tutoring, financial literacy seminars, leadership and career development workshops, advice and assistance in postsecondary course selection, community involvement, cultural enrichment and transfer assistance. To be eligible for TRiO services, a student must be first generation and/or low-income and/or have a physical or learning impairment, and documentation MUST be submitted for qualification into the program.General Information:Legal Last NameLegal First NameLegal Middle InitialChosen/Preferred NameDate of Birth MM slash DD slash YYYY Social Security NumberSex Male Female Citizenship U.S. Citizen or U.S. National Permanent Resident Other If Other Please Define:Address Street Address City State / Province / Region ZIP / Postal Code Phone Number (Cell preferred)Can we send you text messages? Yes No FPC Student EmailPersonal EmailAre you a veteran of the United States military? Yes No Program Eligibility (only 1 required to be eligible)Highest Level of Education Completed by Mother/Guardian? Less than High School High School Graduate Some College Associate Degree Bachelor's degree of beyond N/A Highest Level of Education Completed by Father/Guardian? Less than High School High School Graduate Some College Associate Degree Bachelor's degree of beyond N/A Race (Select all that apply): American Indian/ Native Alaskan Native Hawaiian Pacific Islander Black/ African Asian American White Ethnicity Hispanic/Latino Are you currently receiving financial aid from Frank Phillips College? Yes No On 2023 income taxes, I (the student) was listed as: Dependent (I was included on my parents' taxes) Independent (I cannot be claimed on someone else's taxes) What is the size of your family unit?What is the approximate annual income for your household?Do you have a documented disability or any learning impairment? Yes No Are you receiving services from FPC Disability Services? Yes No What services can TRiO provide to help you?Release of Information* I agree to the Release of InformationI certify that the information on this application, self-assessment, and release is accurate and complete to the best of my knowledge. I understand that The Department of Education requires social security number reporting as a condition for TRiO participation, and that my social security number will remain private and confidential. I hereby authorize TRIO Student Support Services to obtain any information from my educational record that may be pertinent to my participation in the program, including information from Financial Aid, Admissions, the Registrar, Disability Services, FPC employees, and the National Student Clearing House. Your signature gives us the right to use your participation, photos, videos, and likeness to promote the TRiO program. By signing you also agree to allow TRiO Student Support Services to contact you electronically by email and text when applicable (standard messaging rates apply and vary by phone carriers). You may opt out of text messages but messages will continue through student e-mail.Frank Phillips College is an equal opportunity education institution and employer. Its students and employees are selected and/or assigned without regard to age, race, color, creed, sex, national origin, or disability, consistent with Titles VI and VII of the Civil Rights Act of 1964, and Title IX of the Higher Education Act amended in 1972, and Section 504 of the Rehabilitation Act of 1973. The compliance coordinator for Title IX is Jackie Brand (jbrand@fpctx.edu; (806) 457-4200, ext. 715), and Section 504 is Kaisha Yeager (kyeager@fpctx.edu; (806) 457-4200, ext. 777). Frank Phillips College no discrimina por motivos de raza, edad, religión, color, origen nacional, sexo o impedimento en sus programas, servicios o actividades según requerido por el Título VI de la Ley de Derechos Civiles de 1964, según enmienda; el Título IX de las Enmiendas de Educación de 1972; y la Sección 504 de la Ley de Rehabilitación de 1973, según enmienda. FPC también proporciona igualdad de acceso a los Boy Scouts y a otros grupos de jóvenes designados. Preguntas con respecto al cumplimiento y/o procedimientos de queja pueden ser dirigidas al oficial del Titulo IX , Jackie Brand, 1301 West Roosevelt, Borger, Texas 79007, (806) 457-4200, ext. 715, jbrand@fpctx.edu, y/o al Coor-dinador de la Sección 504/ADA del distrito escolar, Kaisha Yeager, 1301 West Roosevelt, Borger, Texas 79007, (806) 457-4200, ext 777, kyeager@fpctx.edu.All About You - TRiO Intake InterviewName First Last What area of study do you intend to pursue?After college, what are your career plans?What is your educational goal? Associate's Degree Bachelor's Degree Master's Degree Doctoral or other professional degree (i.e. PhD, MD, JD, etc.) Not sure Choose the areas in which you feel you may need help in: Assistance with a physical or learning impairment Choosing a major Choosing a career Study skills Computer or technology skills Tutoring Test-taking tips Managing stress Budgeting or financial literacy Overcoming current life obstacles Communicating with faculty Goal-setting Transferring to a four-year university Boosting self-esteem Child care Filling out the FAFSA Locating scholarships Selecting classes Meeting other students or getting involved on campus Are there subjects or classes you need help in?What colleges are you considering transferring to after completing your degree at FPC?What personal goals can we help you achieve?What do you feel is your biggest obstacle to completing your degree that you might be facing?How do you prefer to receive information on TRiO events? Email Social media Website Other If Other Please DefineHow did you hear about the TRiO program?Are there any questions that we can answer for you?Thank you for your responses. They allow us to better help you during your time here at FPC!
