• TRIO Student Support Services Application

    Hopkinsville Community College

  • Thank you for your interest in our Student Support Services program!  Please complete this application as thoroughly as possible.  

    PLEASE NOTE: You cannot save this application, and must complete it in one session. 

    As a reminder, to be eligible for TRIO SSS you must be a current Hopkinsville Community College student who:

    • Is a US Citizen or Permanent Resident
    • Demonstrates academic need for project services 

    AND who identifies as at least one of the following:

    • Low-Income Status based on federal income guidelines
    • First-Generation college student (neither parents have completed a 4-year college degree, or if you were raised by one parent primarily, they cannot have a 4-year college degree)
    • Individual receiving accessibility services through HCC

    Students are accepted into the program based on eligibility criteria, academic need, and space availability. Completion of the application does not guarantee acceptance into the program. 

    CONTACT US | If you have any questions, please call our office at 270-707-3909 or email SSS Administrative Assistant, Teri Bradford at tbradford0022@kctcs.edu.

  • Applicant Information

  • Date of Birth*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Format: (000) 000-0000.
  • Citizenship Status*
  • Gender
  • Ethnicity
  • Race

  • Academic Standing and Goals

  • Are you currently a: (please choose one)*
  • Do you already have an associate's degree or higher?*
  • Do you plan to earn an associate's degree?*
  • Do you plan to transfer to a 4-year university after HCC?*

  • Family Background and Accessibility

  • Did either of your parents/guardians complete a bachelor's degree?*
  • If raised and supported by only one parent/guardian, did that parent/guardian complete a bachelor's degree?
  • Have you registered a documented physical or learning disability with HCC Accessibility Services?

  • According to Federal Financial Aid, you are financially independent if you are any of the following:

    1) 24 years old as of January 1 of the academic year;

    2) married;

    3) have a legal dependent;

    4) a veteran of the US Armed Forces; or

    5) orphan or ward of the court (or was until age 18).

  • Are you an independent student per the above definition?*
  • If no, please utilize income information of your parent/guardian for the following information.*
  • Do you receive financial aid?*
  • Please choose the line that reflects your most recent taxable income (Line 15, Form 1040)*
  • If you are a dependent student, was taxable income verified by your parent/guardian?*

  • Student Support Services Needs and Interests

  • In what way do you feel that Student Support Services will best assist you?
  • What are you interested in exploring with SSS?
  • How would you prefer to hear from SSS?*
  • May SSS text you about program updates, opportunities and events?*
  • How do you attend most of your classes?*
  • How did you hear about SSS?*

  • Sharing, Certification, and Submission

  • Sharing Your Success*

  • RELEASE OF INFORMATION / AFFIDAVIT OF TRUTH

    (a) I give permission for Student Support Services personnel to access my HCC academic and financial aid records for the purpose of verifying project eligibility, potentially awarding grant aid, assisting me academically and/or for transfer purposes.

    (b) I verify my full agreement and understanding of this application. I certify that the information provided is true and complete to the best of my knowledge.

  • Date*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Should be Empty: