ETS English Application 23-24

EDUCATIONAL TALENT SEARCH
WHAT IS EDUCATIONAL TALENT SEARCH?

Educational Talent Search (ETS) is a 100% Federally Funded program offered through Diablo Valley College in partnership with Mt. Diablo Unified School District. Our program aims to provide students and parents with accurate information on post-secondary and financial aid opportunities in order to empower students to attend college/university of their choice after high school. (Total Annual Budget $381,327)
WHAT TYPE OF SERVICES DOES ETS PROVIDE?

Educational Talent Search offers the following services at no cost to students who qualify. Academic Tutoring, Financial Aid, Financial Literacy, ACT/SAT Information, Campus Tours, Career Exploration, Academic Advising, College Planning & Summer Program
WHAT ARE THE ELIGIBILITY REQUIREMENTS?

The ETS program is available to all middle and high school students enrolled at participating schools and who live in our target area at the time of the application. You must also meet at least one or more of the following criteria: a) First generation college student b) Income within federal guidelines c) Academic needs
WHERE IS EDUCATIONAL TALENT SEARCH LOCATED?

Diablo Valley College, Student Services Center, Suite #258 321 Golf Club Road, Pleasant Hill, CA 94523 Office: 925-969-2189Fax: 925-691-9316
Student Application/Information Section
Student Legal First Name:*
No nick names
Student Legal Last Name:*
No nick names
Date of Birth*

MonthDayYear
Date
Gender:*

MaleFemaleOther
Self-Identify:
Pronouns:
She/Her, He/Him, They/Them
Student Phone Number*
Student Email Address:*
Parent Name:*
Parent Phone Number*
Parent Email Address:*
Street Address*

(include apartment number, if applicable)

Street Address Line 2

CityState / Province

Zip
Are you a U.S. Citizen?*

YesNo
SSN:
If not, are you a Permanent Resident?

Yes (if yes, attach picture of card, front and back)No
Permanent Resident Card#:
Please upload picture of Permanent Resident Card Front and Back

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If not, are you in the application process to become a resident?

YesNo
Current School:*
Provide your school name here
Student ID#:*
Current Grade:*

6th7th8th9th10th11th12th
Please upload most recent school transcript. Not required for: El Dorado, Oak Grove, Riverview Middle School, Concord, Mt. Diablo, and Ygnacio Valley High School.

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Are you currently enrolled in another outreach program? (ex. AVID/EAOP/UB/UB Math & Science/GEARUP/etc.)*

YesNoOther
Ethnicity: Check all that apply*

African American/BlackAmerican Indian/Alaska NativeAsian/Asian AmericanCaucasian/WhiteHispanic/LatinoNative Hawaiian/Other Pacific IslanderOther
Needs Assessment 2023-2024

Please check the areas in which you need assistance:
Type a question

College AdmissionsCollege InformationChoosing a majorCampus visitsNote TakingSelf-AwarenessTutoringGrade ReviewsTime managementCourse selectionPaying for CollegeMoney ManagementStudy SkillsTest PrepLoan ForgivenessScholarshipsChoosing a career
1. What do you see as your biggest obstacles for going to college?*
List possible challenges you may face going to college
2. List colleges you are interested in attending.*
3. What major(s) and careers are you interested in?*
4. List current activities, school clubs and jobs:*
Any activities outside of school or at school, list here
I realize that I must meet with my ETS Advisor monthly in order to benefit from program services
Student Name*
Legal First and Last Name
Student Signature*

Clear
Legal First and Last Name
Date*

MonthDayYear
Date
Parent Application/Information Section
Student Name*
Legal First and Last Name
Student School*
Legal First and Last Name
Is your child Hispanic/Latino:*

YesNo
If not, check all that apply*

African American/BlackCaucasian / WhiteAsian / Asian AmericanNative Hawaiian / Other Pacific IslanderOther
Does your child have a physical or learning disability:*

Yes (if yes, attach entire IEP/504 report)No
If yes, specify and attach IEP/504
Please attach IEP/504

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Note: All personal records or documentation will be held in strickest confidence by the staff of ETS, DVC and Contra Costa Community College District (consistent with the Federal Family Education Rights and Privacy Act of 1974, regulations and other laws) and will not be released to any other entity without my prior acknowledge and consent. This acknowledge will be effective for the duration of my child's participation in the program.
Student resides with (if you mark "BOTH" we need information for both parents):*

One Parent/GuardianBoth Parents/Guardians
Language Preference:*
English/Spanish/Other: Please specify here
Parent 1/Guardian
Print Name:*
Legal First and Last Name
Occupation:*
Job Title/unemployed/homemaker/Other: Please specify here
Contact Phone*
Email:*
Parent 1/Guardian Education:*

Elementary/Middle School/Some High SchoolHigh School Diploma/GED2-year college degree4-year college degree
Parent 2/Guardian
Print Name:
Legal First and Last Name
Occupation:
Contact Phone:
Email:
Parent 2/Guardian Education:

Elementary/Middle SchoolHigh School Diploma/GED2-year college degree4-year college degree
Eligibility Certification: I/we the parent(s)/guardian(s) of the above named student had an Annual Taxable Income (fill in the blank) for 2023*
See Line 15 on the 2023 1040 Tax Return
Which supported (fill in the blank) *
Including parents and student, how many people does this income support?
Does applying Student/Parent/Guardian receive any of the following: (Select all that apply):

Social Services Income
Do you have other children in grades 6th - 12th?*

YesNo
If yes, Name of Child 1:
Legal First and Last Name
School name of Child 1:
Please provide school name here
If yes, Name of Child 2:
Legal First and Last Name
School name of Child 2:
Please provide school name here
Participation Agreement and Release
Student Name:*
has my permission to participate in supervised online and in person activities educational, academic, social, cultural, college, career and other college matriculation services and field trips with the Contra Costa Community College District, Diablo Valley College ans Educational Talent Search staff. I realize that this will require my child to interact with and exchange information and images with staff in an online format i.e. Zoom, Loom, Google Classroom, Remind, TAWK, On Track, College Choices, CANVAS, UC Scout, Khan Academy and social mediaI will attend one Parent Workshop per year and understand that occasionally class release time is required for my child to receive in person services.
Parent/Guardian Initials:*
By providing Parent/Guardian Initials, you are agreeing to above statement
I/we do hereby give consent to DVC ETS (employees and agency) to render or seek necessary emergency medical treatment and assistance to the participant/my child. The participant, his/her parents or legally appointed guardian hereby agree to indemnify, hold harmless, release and forever discharge the DVC Educational Talent Search employees and/or agents from all claims and demands which the participant, his/her parents or legal guardian or the representatives or successors of them or any person may have against Contra Costa Community College District, DVC and its employees and agents by reason of acts, illness, or injury, or other consequences arising or resulting directly or indirectly from the participation of said minor in the aforementioned ETS activities.
Parent/Guardian Initials:*
By providing Parent/Guardian Initials, you are agreeing to above statement
Student Initials:*
By providing Student Initials, you are agreeing to above statement
I/we authorize the DVC ETS to obtain documents concerning my child’s education, which include: a copy of my child’s school transcript, test scores, ACT/SAT and school lunch program eligibility. I/we hereby give my permission for my child’s name, photograph, work, and/or statements for use by DVC ETS for promotional, publicity web pages, social media, brochures, newspaper, etc and for instructional purposes.
Parent/Guardian Initials:*
By providing Parent/Guardian Initials, you are agreeing to above statement
I do hereby give my college of attendance and National Student Clearinghouse permission to disclose my college enrollment status and degree attainment data to the CCCCD/DVC ETS staff for the purpose of tracking my college enrollment and completion. I authorize ETS to obtain information related to my application for receipt of student financial assistance (federal, state, or other) and a copy of my award notification from the financial aid office and college admission registration information.
Student Initials:*
By providing Student Initials, you are agreeing to above statement
Print Parent 1/Guardian Name:*
Legal First and Last Name
Parent/Guardian Signature*

Clear
Date*

MonthDayYear
Date
Parent 2 / Guardian Name:
Legal First and Last Name
Parent 2 / Guardian Signature

Clear
Date

MonthDayYear
Date
Student Name:*
Legal First and Last Name
Student Signature*

Clear
Date*

MonthDayYear
Date
STOP!

Please review your application before submitting and be sure the following is included:
- Parent and student has provided and signed legal first and last name
- Contact information including:
  - phone/cell
  - email addresses
- Citizenship/Permanent Residency status
- Ethnicity
- Annual Taxable Income and Number of people it supported
- Transcript and/or IEP/504, or Permanent Resident docuements has been uploaded
Review Common Application Mistakes:

1. Misspelled first and last name

2. Misspelled email/Wrong phone numbers

3. Not including both parents/guardian information when checking box indicating residing with both parents/guardians

4. Transcript and/or IEP/504 or Permanent Resident docuements not uploaded

Any questions?

Follow up with your ETS Advisor:

ETS Advisors

DVCETS@DVC.edu

Ms. Brenda, bmendezmora@dvc.edu, 925-969-2010
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EDUCATIONAL TALENT SEARCH

WHAT IS EDUCATIONAL TALENT SEARCH?

WHAT TYPE OF SERVICES DOES ETS PROVIDE?

WHAT ARE THE ELIGIBILITY REQUIREMENTS?

WHERE IS EDUCATIONAL TALENT SEARCH LOCATED?

Student Application/Information Section

Needs Assessment 2023-2024

I realize that I must meet with my ETS Advisor monthly in order to benefit from program services

Parent Application/Information Section

Parent 1/Guardian

Parent 2/Guardian

Participation Agreement and Release