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?

Gender

How did you learn about Talent Search?

Ethnicity

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:

What do you plan to do after you graduate from high school? (Check One)

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

Date of Signature

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

Date

Who does the student live with MOST of the time:

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)

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

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:

Total number of people in household, including student (select one)

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?

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

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

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.

PARENT SIGNATURE IS REQUIRED (SIGN BELOW)

PARENT / GUARDIAN SIGNATURE

Parent/Guardian Printed Name (typed)

First NameLast Name

Date of Signature

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:

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?

If "YES" please provide their name.

Do you have Internet connection at home?

If YES, list your Internet provider

Spectrum, Windstream, etc.

What device(s) do you use to access the internet?

Would you be willing to participate in our monthly Talent Search meetings via Internet with your Talent Search Counselor?

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