TRIO SSS Information Request

Name*

First NameMiddle NameLast Name

First Name*

Middle Initial

Last Name*

Mid Student ID*

You can find your Student ID Number on your Mid Michigan College Student ID Card or in your Self-Service Account.

Email Address (MidMich email if you have one)*

example@midmich.edu

Preferred Phone*

How would you prefer to get more information?

EmailPhone

Does either of your parents (natural or adoptive) hold a bachelor's degree?*

Do you have a documented disability that impacts your success in college?*

YesNo

Have you completed a FAFSA for the current academic year?*

YesNo

Have you been approved for financial aid?

YesNo

Will you receive a Pell Grant?

YesNo

Are you a high school or GED graduate?*

YesNo

Year of graduation

Are you a current Mid student?*

YesNo

Grade Level at Mid

What certificate or degree are you pursuing?

Significant effort has been made to ensure this content meets accessibility guidelines. If you encounter a barrier you can report the barrier at midmich.edu/reportaccessibilitybarrier or contact TRIO-SSS at (989) 317-9211 or trio@midmich.edu.

In its commitment to providing a safe environment, Mid Michigan College actively endeavors to broaden our diversity, promote equal opportunity, and prohibit any form of discrimination in its programs, activities, and conditions of admission or employment. Learn more about these efforts and policies by visiting midmich.edu/eeo, midmich.edu/titleix, midmich.edu/securityreport.