• TRIO Student Support Services

    TRIO Student Support Services

    Application Form 
  • Birth Date*
     - -
  • Citizenship:*
  • Gender:*
  • Veteran:*
  • Type a question*
  • Date
     - -
  • Educational Goals*
  • Ethnicity*
  • Race*
  • Are you receiving assistance paying for college? Please check all that apply*
  • Do you have a GED?*
  • Are you a transfer student?*
  • Do you have documentation of a disability? (Disabilities include, but are not limited to: ADHD, asthma, CP, diabetes, depression, anxiety, Tourette's, hearing impairment, MS, PTSD, etc.)*
  • Will you be requesting accommodations under the American Disabilities Act?*
  • Highest level of education completed by your Father: (Applicable if you regularly resided with and received support from this parent or legal guardian during your K thru 12 education)
  • Highest level of education completed by your Mother: (Applicable if you regularly resided with and received support from this parent or legal guardian during your K thru 12 education)
  • Does your taxable income fall within the category for your family size on the following table?*

  • Eligibility Table effective January 15, 2025 until further notice

    Family Size 48 Contiguous States, D.C.,
    and Outlying Jurisdictions    		 Alaska Hawaii
    1 $0 - $23,475 $29,325 $26,985
    2 $0 - $31,725 $39,645 $36,480
    3 $0 - $39,975 $49,965 $45,975
    4 $0 - $48,225 $60,285 $55,470
    5 $0 - $56,475 $70,605 $64,965
    6 $0 - $64,725 $80,925 $74,460
    7 $0 - $72,975 $91,245 $83,955
    8 $0 - $81,225 $101,565 $93,450

    **For family units with more than eight members, add the following amount for each additional family member: $5,500 for the 48 contiguous states, DC and outlying jurisdictions; $6,880 for Alaska; and $6,330 for Hawaii.

    Your TAXABLE income can be found on line 15 of the 2023 form 1040, or line 15 of the 2024 form 1040. Taxable income is typically less than Adjusted Gross Income, which is reported on a FAFSA, because of deductions. Please contact the TRiO-SSS office or submit a copy of your tax form along with this application if applicable.

  • Please check the services/areas where you have or may have a need for academic assistance*
  • Learning Skills Development
  • Tutorial Assistance
  • Advising
  • Other

  • I certify that the information written on this application is true and correct to the best of my knowledge. With this application I authorize TRIO Student Support Services to obtain from Minot State University’s Financial Aid Office, Registrar's Office and Disability Services Office, all financial, academic and disability related documentation/ records pertinent to my eligibility and participation in TRIO Student Support Services. I further authorize the TRIO Student Support Services program to access enrollment and degree information from the National Student Clearinghouse for retention and graduation data required by the U.S. Department of Education. I understand that the program only serves a limited number of students, acceptance is not guaranteed and my name may be placed on a waiting list until an opening becomes available.

  • Date
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