• Application & Information Release Form

    Application & Information Release Form

    (PARENT/GUARDIAN - MUST COMPLETE FORM

  • Dear Parent(s)/Guardian,

    Below is the online application for the Educational Talent Search Program.  This program is free to qualifying participants with the potential and desire for education beyond high school, either at the college level, technical/vocational school or registered apprenticeships. For more information, please read our Parent Letter HERE.

    ETS is designed to give your child the tools they need to have the most options

    Please complete the application below.  If you have any questions or concerns, please reach out to one of our offices for assistance.

    Vincennes University - Main:  812-888-4298

    Vincennes University Gibson Center - E'ville:  812-888-2878

    Sincerely,

    ETS Staff

  • Student Information

  • Format: (000) 000-0000.
  • Student's Birthdate*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Sex*
  • Ethnic Origin:*
  • Select ALL that apply - Race:*
  • Please check ALL that apply - STUDENT LIVES WITH:*
  • Please check ALL that apply - STUDENT RECEIVES FINANCIAL SUPPORT FROM:

  • Parent Information

    Please Identify the Adult(s) that the Student LIVES with.
  • Format: (000) 000-0000.

  • Format: (000) 000-0000.

  • Format: (000) 000-0000.

  • In order to fulfill United States Department of Education and Department of Labor Regulations concerning parental college status and income disclosure, it is necessary to complete the following for participation in this grant program.

  • Has the Student's living natural or adoptive Mother graduated from a 4-year college and obtained a Bachelor's Degree?*
  • Has the Student's living natural or adoptive Father graduated from a 4-year college and obtained a Bachelor's Degree?*
  • If your family or student is participating in any of the following programs, please check all that apply:

  • INCOME ELIGIBILITY WORKSHEET

    (for use with 2025 tax information - optional)

  • 1.Enter Your Adjusted Gross Income HERE: $       
       

  • 2. Subtract STANDARD DEDUCTION: (Select from information below) Married filing jointly .................. $31,500 Married filing separately ....... $15,750 Head of Household ................... $23,625 Single ...................................... $15,750 Qualifying Surviving Spouse .....$31,500
  • REQUIRED - Please check one of the following Family TAXABLE INCOME Ranges. Taxable Income is usually LOWER that Adjusted Gross Income. (This information is in 3. of the Income Eligibility Worksheet above - OR - You can locate this information on line 15 on the 2025 Form 1040.)*
  • Which service/activities do you feel your student needs assistance with to prepare for college or post-secondary education? Please CHECK ALL that apply.

  • TERMS AND CONDITIONS

    For participation in ETS

  •  

    The release of records is required for program participation.  I authorize counselors or school personnel to release my child’s transcript information regarding educational progress, behavior, attendance, free and reduced lunch eligibility, any financial aid award, and enrollment status to ETS. I authorize the State of Indiana to release educational and financial aid records, including 21st Century Scholars and Scholartrack. I authorize ETS to transmit this information for the purpose of assistance in making career and post-secondary educational plans.  I relieve ETS of any responsibility for accidents, illnesses, or injuries that may result from participation, and I authorize the use of my child’s photo in ETS publications, newsletters, and websites.  If I do NOT authorize ETS to use my child's photo for media purposes, I must email etsvu@vinu.edu with details and receive confirmation from the ETS Staff.  I also agree to encourage my student in his/her plans to successfully complete high school and enter an institution of post-secondary education. 

    I give ETS permission to contact my student and myself, via cell phone/text or email.  I will provide updated information to ETS by calling the office at 812-888-4298, if our address, phone number(s) or emails should be changed.

    Please be advised that this information will be kept strictly confidential, and will be used only for eligibility determination, student demographic recordkeeping, federal reporting, and other administrative purposes.

  • By SIGNING, I certify that the information given here is true and correct and that I have read and agree to the TERMS AND CONDITIONS above for my student to participate in Educational Talent Search.

  • Signature*
  • Date*
     - -
    2 digit month, 2 digit day, 4 digit year

  • Office use only:  Received _______  Outreach Advisor _______   Director _______

     

    Eligibility:  FG ______    LI ______  LI/FG ______   Other ______     Student Prefers to be called:  __________________________

  • Should be Empty: