TRIO Talent Search Referral Form

TRIO Talent Search Referral Form
Please fill out the following information to refer a student to our program.

TRIO Talent Search is a federally funded program aimed at helping first-generation students who are interested in attending college. All aspects of our program are free including transportation, food, educational materials, tickets, etc. Please email Talent Search (talentsearch@kcc.edu) if you are unable to complete all the information below or have additional questions. For more information, check out our website at talentsearch.kcc.edu
Student's Full Name*

First NameLast Name
Student ID# or Email Address*
example@example.com
Parent/Guardian's Full Name*

First NameLast Name
Parent Phone Number (if applicable)*
Please enter a valid phone number.
School Name*
Current Grade Level*
What services could assist in this student's success? (Select all that apply)*

Homework & GradesStudy Habits, Note-taking, test preparation, and time managementGoal Setting, academic attitude, and collegeprep coursesCultural awareness- exposure to a variety of cultural activitiesMentoring servicesCareer Exploration & GuidanceCollege Admission ProceduresScholarship InformationFinancial Literacy InformationTransition from middle school to junior high / junior high to high schoolAssistance returnin to secondary or post secondary educationOther (please specify):
Please explain what other services would be beneficial to the student:
Additional Comments or Notes:
Referred by: (Name, Contact Info & Relation to the student). We will only contact you if more information is needed.*
Signature*

Powered by Jotform SignClear
Should be Empty:

TRIO Talent Search Referral Form

Please fill out the following information to refer a student to our program.