PY 25-26 Step 1: EOC Program Application

EOC Program Application

The US Department of Education requires us to collect certain information from persons desiring to receive EOC services in order to determine their eligibility for FREE program services. All collected information is confidential.
NEEDS ASSESSMENT: The HEC TRIO Educational Opportunity Centers provide FREE college access services which include but are not limited to the following: financial aid application assistance, scholarship searches, college searches, college application assistance, student loan consolidation, student loan default remedies, career assessment, employment outlook information, personal counseling, community resource information, and academic tutoring for the GED/HiSET and college placement tests.
First Name
First Name
Last Name
Last Name
Phone Number (if none, enter zeroes)
Please enter a valid phone number.Format: (000) 000-0000.
Date of Birth

MonthDayYear
Date
Check ALL that apply.
Email Address (Enter NONE if not-applicable)
Last 4 Digits of Social Security Number OR Create a 4 Digit Code
Citizenship Status

Other
If You are an Eligible Non-Citizen, Please Upload a Copy of your Permanent Resident Card, Resident Alien Card, or Alien Registration Receipt Card, I-94 Form or T-Visa

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English Is My Primary Language
Gender
How Are You Military Connected?
Race and Ethnicity. CHECK ALL THAT APPLY
What is Your Zip Code?
County of Residence
Including Yourself, How Many People Are in Your Household?
Where Does Your 2024 TAXABLE Household Income Fit?
Are You a 1st Generation College Student (NEITHER Biological/Adoptive Parent Has Received a 4-Year Bachelors Degree)?
Your Current Grade Level CHECK ALL THAT APPLY:
If you selected Enrolled in College, select the college below:

Other
Do You Currently Receive Services From Another Federally Funded Program? CHECK ALL THAT APPLY.
How Did You Hear About Us? CHECK ALL THAT APPLY.
Are you currently working with one of our College Access Coaches?
PARTICIPANT SIGNATURE: I hereby certify that all of the information on this application is true and correct to the best of my knowledge. I understand that all of the information on this application is confidential and will be used for program recording, tracking, and reporting as required by the U.S. Department of Education. I give HEC TRIO Educational Opportunity Centers the right to reproduce, distribute, transmit, publish, display, in whole or in part, either digitally or in any other medium used my name and/or photographic image. I authorize HEC TRIO Educational Opportunity Center (HEC TRIO EOC) staff to verify my college, academic, enrollment, and financial aid information through National Student Clearinghouse, National Student Loan Data System, and other third-party entities.
Parent's Name

First NameLast Name
Parent's Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Parent's Email Address
example@example.com
PARENT SIGNATURE IS REQUIRED if the applicant is not a veteran or is not married or does not have a dependent of their own or are under the age of 24. I hereby certify that all of the information on this application is true and correct to the best of my knowledge. I understand that all of the information on this application is confidential and will be used for program recording, tracking, and reporting as required by the U.S. Department of Education. I give Higher Education Consortium the right to reproduce, distribute, transmit, publish, display, in whole or in part, either digitally or in any other medium used my name and/or photographic image. I authorize HEC TRIO Educational Opportunity Center (HEC TRIO EOC) staff to verify my college, academic, enrollment, and financial aid information through National Student Clearinghouse, National Student Loan Data System, and other third-party entities.
Date & Time of Submission
Should be Empty: