TALENT SEARCH APPLICATION

TALENT SEARCH APPLICATION
Talent Search is a program that works with the guidance counselor's office at your local school to assist students in graduating high school and enrolling in a college or university.

Talent Search is funded by the United States Department of Education.

All applicants are selected without regard to race, color, national origin, gender, age, or disability The program is sponsored by Morehead State University

ALL SERVICES ARE FREE!

Morehead State University
204 Education Services Building Morehead, KY 40351
Telephone: (606) 783-2977 or Toll-Free: (877) 874-6387 Fax: (606) 783-5033
Morehead State Talent Search serves middle and high schools in the following service area: Carter, Lewis, Morgan, Menifee, Elliot, Rowan, Johnson, Greenup, Bath, Powell, Magoffin, and Wolfe.
STUDENT INFORMATION
to be completed with student information ONLY
Name*

First NameMiddle NameLast Name
Preferred to be called
(Nickname, Name you go by everyday)
SSN ____ ____ ____-_____ _____ -______ _____ ______ _______
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
STUDENT Cell (if applicable)

Area CodePhone Number
STUDENT Home Phone*

Area CodePhone Number
STUDENT Email (most used account)
example@example.com
STUDENT Email (school account)*
example@county.kyschools.us
Current Grade*
Ex. 6th Grade
Current School District*
Current School
School Name
U.S. Citizen?*

YesNo
Gender*

FemaleMale
How did you learn about Talent Search?*

School Guidance CounselorFriend/Current Talent Search MemberSocial MediaBack to School EventOther
Ethnicity*

AsianAfrican AmericanHispanicNative AmericanWhiteOther
Are you currently participating in any other college preparatory programs? (i.e. Upward Bound, GEAR UP, etc.)*
YES or NO: If YES please specify which program
Do you have brothers and/or sisters (currently or previously) in Talent Search?*
YES or NO: If YES please provide their name
I am interested in joining TRIO Talent Search because I would like help with/information about:*

TutoringAcademic Advising/MentoringCollege Exam PreparationsScholarship/Financial Aid InfoFinancial LiteracyCollege Admissions AssistanceCareer InformationCommunication SkillsStudy SkillsCollege VisitsCharacter DevelopmentAcademic CounselingCultural Awareness & DiversityDecision MakingConflict ResolutionOther
What do you plan to do after you graduate from high school? (Check One)*

4-Year Institution (MSU, UK, EKU, WKU, Murray, UofL, etc)Community College (ACTC, MCTC, Big Sandy, Bluegrass, etc)Trade/ Vocational SchoolMilitaryWorkOther
If selected, how can Talent Search help you meet your goals after high school graduation?*
Provide answer in text box
If accepted into the Talent Search Program, I agree to meet with my
Talent Search Academic Coordinator, attend meetings, do my best academically and prepare to work towards a college education
(SIGN BELOW)
STUDENT Signature*

Clear
Date of Signature*

MonthDayYear
Date
CONFIDENTIAL
Eligibility Information
HOUSEHOLD / FAMILY INFORMATION
(To be completed by parent(s) or guardian(s) ONLY)
STUDENT Social Security #*
Student SSN is required to process this application
STUDENT Date of Birth*

MonthDayYear
Date
Who does the student live with MOST of the time:*

Both ParentsMotherFatherGrandparentsFoster ParentsAunt / UncleOther
Please list name(s) of whom student lives with MOST of the time:*
Ex. Jane Doe (Mother), John Doe (Grandfather), etc.
Talent Search is a program funded to serve a percentage of students who meet the eligibility criteria of low-income, first generation potential college student status, meaning neither parent has a four year college degree.

In meeting this federal regulation we ask that you provide the following information used to determine eligibility. The information you provide is strictly confidential and used solely for the purpose of determining program eligibility.
Does either parent (biological or adopted) have a 4-year college degree?(WHO THE STUDENT LIVES WITH)

YesNo
What is the HIGHEST level of education obtained by either parent, biological or adopted. (WHO THE STUDENT LIVES WITH)*

Master's Degree (or higher)Bachelor's DegreeAssociates DegreeProgram CertificateHigh School Diploma or GEDSome High School8th GradeOther
If either parent (biological or adopted) has a college degree, what was the program of study and where was the degree obtained? (Ex. Bachelor's in Psychology at Morehead State University)
Ex. Associates in Accounting ACTC
Does anyone in the household QUALIFY for the following:

Free School LunchReduced Price School LunchEBT (Food Stamps)WICSupplemental Security Income (SSI)Temporary Assistance for Needy Families (TANF)
Total number of people in household, including student (select one)*

12345678910 or more
NOTE: Do not use gross or net income, but TAXABLE INCOME
which is typically much lower. Please review line 15 of the IRS form 1040 from your taxes to find this information, (indicate range below)
What was your household’s TAXABLE INCOME last year?*

No taxable income (SSI, SSDI, WIC)$1 - $23,475$23,476 - $31,725$31,726 - $39,975$39,976 - $48,225$48,226 - $56,475$56,476 - $64,725$64,726 - $72,975$72,976 - $81,225$81,226 or more
RELEASE OF RECORDS

The “Release of Records” is required for program participation. Records will be used to assess student needs, monitor progress, document eligibility and for reporting purposes. This information is confidential and protected under the General Education Provision Act. Talent Search will not release any confidential information without your written consent.
I hereby grant permission for the Talent Search program at Morehead State University to have access to educational records of NAME OF STUDENT* including (but not limited to) grades, test scores, free/reduced price lunch eligibility, class schedules, postsecondary enrollment, discipline records and attendance for the duration of the student’s enrollment in the MSU Talent Search Program. This also authorizes the postsecondary institutions to release to the MSU Talent Search program copies of college academic enrollment and student aid award information.
I authorize the use of my child’s photo by TS for publicity and recruitment purposes for the duration of the student’s involvement in the TS program*

YESNO
I authorize TS counselors to access my child’s Infinite Campus Portal*

YESNO
I give permission for Talent Search staff to communicate with me or my child using phone, text, email, or other appropriate methods to provide program support and updates when necessary (scholarship opportunities, field trip reminders, etc) *While TRIO Talent Search is not governed by Kentucky Senate Bill 181, this permission helps ensure safe and effective communicated with students and families.

YESNO
PARENT SIGNATURE IS REQUIRED (SIGN BELOW)
PARENT / GUARDIAN SIGNATURE*

Clear
Parent/Guardian Printed Name (typed)*

First NameLast Name
Date of Signature*

MonthDayYear
Date
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Cell Phone*

Area CodePhone Number
Home Phone*

Area CodePhone Number
Work Phone

Area CodePhone Number
Email
example@example.com
The BEST way to contact me is:*

Home PhoneWork PhoneCell PhoneEmail
EMERGENCY Contact (someone other than the primary caregiver)*

First NameLast Name
EMERGENCY Contact Phone #*

Area CodePhone Number
Were you referred by another Talent Search student?

YesNo
If "YES" please provide their name.
Do you have Internet connection at home?*

YesNo
If YES, list your Internet provider
Spectrum, Windstream, etc.
What device(s) do you use to access the internet?

Cell PhoneLaptopDesktop ComputerTablet / iPadOther
Would you be willing to participate in our monthly Talent Search meetings via Internet with your Talent Search Counselor?

YesNo
Are you familiar with any of the following? (Check all that apply)

ZOOMKahootWebexGotoMeetingsBlackboardSkypeGoogle Classroom
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