Application

Application Form

TRIO Pre-College Programs (Talent Search & Upward Bound) are 100% funded by the U.S. Department of Education and hosted by Michigan Technological University.
TRIO Eligibility Requirements*
- Potential first-generation college student whose birth/adoptive parents have not earned a four-year college degree AND
- Household income falls within the Federal Income Guidelines
  Note: Students in foster care or who have a court-appointed legal guardian (who has not officially adopted them) are automatically eligible.
*There are a limited number of spots to accept students who do not fully meet the eligibility requirements.
Need more information before you apply?

Click the TRIO logo below.
Date Received

MonthDayYear
Date
Status
Director Signature
Student Information
Name*

Legal First NameMiddle Initial (if none put N/A)Legal Last Name
Date of Birth*

MonthDayYear
Date
Mailing Address*

Street Address

Street Address Line 2

CityState

Zip Code
Grade*
School*
Student Email*
example@example.com
Student Phone Number*
Please enter a valid phone number.
Does this phone receive texts?*

YesNo
Gender (assigned at birth)*

MaleFemale
Is the student a U.S. Citizen?*

YesNo
If no, one of the following is required: a photocopy of the student's Alien Registration Card or a copy of both the Application for Permanent Residency and the student's Arrival-Departure Record
Student's race/ethnicity (check all that apply)*

Caucasian/WhiteAfrican American/AfricanHispanic/LatinoAmerican Indian or Alaska NativeNative Hawaiian/Pacific IslanderAsian American/AsianOther
Do you have a court appointed legal guardian, are you a ward of the state, or are you in foster care?*

YesNo
Please provide your legal guardian and/or caseworker's Name, Email Address and Phone Number. *
How can TRIO help you? (check all that apply)*

Academic SupportCareer ExplorationCollege Preparation
All applicants completing this form will be considered for TRIO Talent Search. Upward Bound is only offered in the Copper Country ISD High Schools. Would you also like to be considered for TRIO Upward Bound?*

Yes, please!No, thank you.
Family Income Information: (using 2023 Federal Income Tax Information)

NOTE: If parent’s are separated or divorced, use the information for the parent the student lives with the most.
Please enter the total number of people living in the student’s household including the student: *
Please check the box that best represents the 2023 taxable household income (found on line 15 of the 1040 tax form) NOT THE GROSS INCOME:*

Was not legally required to file a 2023 tax returnAlthough required, 2023 tax return not yet filed$0- $22,590$22,591- $30,660$30,661- $38,730$38,731- $46,800$46,801- $54,870$54,871- $62,940$62,941- $71,010$71,010- $79,080$79,081 and above
Please provide the Federal 2022 Taxable Income (found on line 15 of the 1040 tax form) NOT THE GROSS INCOME*
Family Information/Education
Student lives with (check all that apply):*

Birth/Adoptive MotherBirth/Adoptive FatherGrandparent(s)Other
Parent/Guardian Information
Parent/Legal Guardian 1*

First NameLast Name
Relationship to Student*
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Does this phone receive texts?*

YesNo
College Education*

None/someAssociate's DegreeBachelor's Degree (or higher)
Parent/Legal Guardian 2

First NameLast Name
Relationship to Student
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState

Postal / Zip Code
Phone Number
Please enter a valid phone number.
Does this number receive texts?

YesNo
College Education

None/someAssociate's DegreeBachelor's Degree (or higher)
How did you hear about TRIO? (check all that apply)*

Classroom presentationFriend/Family memberLetter/Postcard in mailSocial MediaTeacher/CounselorCommunity FlyerTRIO representative at lunchOther
I hereby certify that the above is true and complete to the best of my knowledge and give my permission for TRIO Pre-College Programs (Talent Search & Upward Bound) the right to take photographs and videos of my student in connection with TRIO sponsored events. I authorize TRIO Pre-College Programs to use and publish these photos and videos on their website, social media, and promotional materials. I also give my permission for TRIO Pre-College Programs to access my academic records information, including but not limited to grades/transcripts, class schedule, test scores, and teacher evaluations.
Student Name*

First NameLast Name
Student Signature*

Clear
Date*

MonthDayYear
Date
Parent/Legal Guardian Signature*

Clear
Date*

MonthDayYear
Date
Revised May 2024
Should be Empty:

Application Form

Need more information before you apply?

Student Information

Family Income Information: (using 2023 Federal Income Tax Information)

Family Information/Education

Parent/Guardian Information