Summer Scholars Application

Summers Scholars Application
Adams State University Student Support Services
Student Support Services (SSS), a TRIO program funded by the U.S Department of Education, provides access and support to students who are first generation, meet federal income guidelines, and/or who have disabilities. Our goal is to retain and graduate students, while fostering academic success and promoting personal growth.

Summer Bridge is the lead-in component to the general SSS program. We also offer individual tutoring, peer mentoring, educational/cultural trips, and one to one academic/financial aid counseling. Additional meetings cover topics such as resume writing, organizing research papers, and searching for scholarships. Students enjoy access to the computer labs, textbook library, and free copying and printing.

The Summer Scholars component of SSS is an intensive three-week academic experince for up to 40 incoming first-year students. The primary purpose is to assist students as they transition from high school to college. Since 2004, our participants have succeeded at higher rates than many of their peers at Adams State. Acceptance into Summer Scholars means acceptance into the SSS program for the duration of a student's academic career at Adams State.

Applications will be accepted until all spots are filled, with consideration given to applications completed by July 4th, 2025 (The program will take place July 6th-26th).

Questions? Please call (719) 587-7632 or email: sss@adams.edu
SSS Summer Scholars Benefits
There are many benefits of the SSS summer scholars component. Students gain improved college-level reading and writing skills, receive additional assistance with math and learn about the Adams State campus. They have the opportunity to make new friends and meet Adams State faculty and staff. Finally, students are better prepared to enter Adams State and to succeed in their first year.

Our high-quality program includes the following benefits at no cost to the students:
- Take a refresher course in math 097 or math 099
- A chance to fulfill English 101 or 102 requirements
- A chance to fulfill FYS course requirement (FYS 102 for TRIO SSS)
- One-on-one academic and financial counseling from SSS staff
- Academic tutoring from professional staff members
- Mentoring from resident advisors/mentors
- Educational trips and extracurricular activities
- Free materials including books, necessary supplies, a t-shirt, and computer access/training
- Up-to $500 Scholarship (upon successful completion of summer and fall FYS courses and pending Adams State approval)
- FREE on-campus room and board for three weeks
To determine eligibility, please complete this form. The information provided is strictly confidential. This information is required because this is a federally funded program and students who wish to participate must meet certain requirements.
Name*

First NameLast Name
Email*
example@example.com
Social Security Number (SSN)*
Copy of SSN card *

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Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Date of Birth*

MonthDayYear
Date
Copy of ID*

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Assigned Birth Sex*

MaleFemale
Ethnicity/Race*

HispanicWhiteBlack or African AmericanAsianAmerican Indian/Alaskan NativeNative Hawaiian or IslanderOther
Parent/Guardian Information
Parent/Guardian Full Name

First NameLast Name
Parent/Guardian Phone Number
Please enter a valid phone number.
Is your Parent/Guardian's address different than yours?

YesNo
Enter other address here
Emergency Contact Information

Who do we contact in case of an emergency?
Emergency Contact Relationship *
Emergency Contact's Name*

First NameLast Name
Cell Phone Number*
Please enter a valid phone number.
Does your emergency contact have the same address as you?*

YesNo
Enter other address here
Upload Copy of Current Medical ID/or Insurance Card

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Eligibility
Eligible students are those who have recently graduated from high school and have already been accepted and plan to attend Adams State University in the fall 2025 semester. The student must be planning to earn a bachelor's degree from Adams State and be willing to make a commitment to participate in the SSS program for the duration of the time they are at Adams State.

Participant must also be a U.S. Citizen or Permanent Resident of the United States. Finally, they must meet at least one of the following requirements.
- Qualify as a first generation student (neither parent has completed a U.S. four-year college degree)
- Meet income requirements determined by federal guidelines, or
- Have a documented disability (Adams State disability verification required)
Citizenship*
Resident Alien Number
Father's Education*
Mother's Education*
Disability
Do you have a disability that is, or can be, documented through Adams State University Disability Services?*

YesNo
Are you registered with Vocational Rehabilitation?*

YesNo
Have you been diagnosed with a learning disability?*

YesNo
Have you been diagnosed with a physical disability?*

YesNo
Tax Information

Important: In order for us to determine your income eligibility, you must submit the most recent income tax return(s) to our office. Dependent Students- the most current tax return (2024) from the parent(s) and the student (if the student worked and filed taxes) needs to be submitted. Independent Students- your most current tax return needs to be submitted. If a student is independent and did not work please complete the Statement of Income Certification Form (provided by SSS staff).
Tax Form*

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Parent's Taxable Income
Student's Taxable Income
Number of People in the Household listed on your FAFSA*
Academic Information
Enrollment*
From Where?
Enrollment Status*
College Grade Level*
Current or High School GPA*
College Major*
Minor
Do you expect to graduate from ASU within 6 years?*

YesNo
Why?
Have you participated in any TRIO programs? (check all that apply)

Educational Opportunity CenterTalent SearchUpward Bound
Academic Needs (check all that apply)*

TutoringPeer MentoringStudy SkillsTest Taking/AnxietyTime ManagementNote TakingStress ManagementPersonal CounselingCareer Assessment/ Exploration/ Choosing a MajorScholarship/ Financial Aid Assistance
References

Please provide information for three references (not a close relative) who can speak to your potential for academic and personal growth.
Reference #1 Name *

First NameLast Name
Reference #1 Phone Number *
Please enter a valid phone number.
Reference #2 Name *

First NameLast Name
Reference #2 Phone Number *
Please enter a valid phone number.
Reference #3 Name*

First NameLast Name
Reference #3 Phone Number *
Please enter a valid phone number.
Personal Essay Information

Your response to the following questions will allow the selection committee to learn more about you personally, as well as your writing style.
Please type your answers, doubled spaced. At least one full paragraph for each question is required in order to be considered complete.

1) Explain why you believe you should be chosen for the SSS Summer Bridge component?

2) Will you be pursuing a B.A degree at ASU? What will your major be? What career are you seeking?

3) Are you willing to participate in the Student Support Services until you graduate from ASU? Why?

4) Discuss one experience that changed your life.
Upload Your Personal Essay Here*

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Release of Records

I (the student) grant permission to the Student Support Services program staff to secure the necessary information (e.g. financial data, standardized test scores, college and High school transcripts, midterm grade requests from instructors) from the Financial Aid Office, Admissions, Records, academic departments and other places of record that SSS deems necessary. I authorize SSS staff to release information to ASU faculty and staff, or gather information from faculty and staff, pertinent to my participation in SSS and Adams State University.
I certify that all information I have provided is true and correct to the best of my knowledge. I authorized Adams State University and Student Support Services staff to use the data provided in this application in assessing any academic and/or career-planning needs.

By signing this form, I understand that all information will be kept strictly confidential.
Parent's/Contributor's Signature (for parent's/contributor's taxable income only)

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Student Signature*

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Date*

MonthDayYear
Date
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Summers Scholars Application

Adams State University Student Support Services

SSS Summer Scholars Benefits

Parent/Guardian Information

Emergency Contact Information

Eligibility

Disability

Tax Information

Academic Information

References

Personal Essay Information

Release of Records