SSS Application

SSS Scholars Program* Application:

*The UWA SSS Scholars Program is a TRIO Student Support Services (SSS) grant funded by the Department of Education
How can the SSS Program help you? (You may select more than one.)*

Assistance with FAFSA and/or KHEAA verificationUnderstanding federal financial aid and how to use it wiselyApplying for scholarshipsIdentifying a major/careerAcademic advising/degree planningApplying to graduate schoolsDeveloping study skills (time management, note taking, test taking...)Tutoring for specific coursesPersonal Mentoring/CounselingOther
Demographic Information:
Name*

First NameMiddle InitialLast Name
Preferred name, if you don't go by your first name
What would you like us to call you?
Date of Birth*
M/D/YYYY
UWA Student ID#
ex: 0356767
Sex assigned at birth - We are a federally funded program and are therefore are required to report data (including sex) to the U.S. Department of Education.*

FemaleMale
Gender Identity - It is important to our program that we support all students’ experiences. If you identify differently than your assigned sex, and if you would like us to know, please share your gender identity below.

FemaleMaleOther
What are your pronouns?

she, her, hershe, him, histhey, them, theirsOther
Are you Hispanic or Latino? (a person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin regardless of race)*

NoYes
Race: (You May Select More Than One)*

American Indian/Alaskan NativeAfrican American/BlackAsianNative Hawaiian/Other Pacific IslanderWhite/Caucasian
Are you an American citizen?*

YesNo
If you are not an American citizen, are you a permanent resident of the U.S.?

YesNo
If you are a permanent resident, what is your permanent resident card number?
ex: 123-456-789
Cell Phone*

Area CodePhone Number
Email*
example@example.com
UWA Email address*
example@uwa.edu
Mailing Address*

Street Address

Street Address Line 2

CityState

Zip CodeCountry
First Generation Status:
What is the highest level of education your biological or adoptive mother attained?*

Some high schoolHigh school/GED graduateSome college/2 year/Community College/Associate's Degree4 year Bachelor's Degree or higherUnsure
What is the highest level of education your biological or adoptive father attained?*

Some high schoolHigh school/GED graduateSome college/2 year/Community College/Associate's Degree4 year Bachelor's Degree or higherUnsure
Who did you most often live with until your 18th birthday?*

Both parentsMotherFatherNeither
If you lived with someone besides your biological/adoptive parent(s), what is their relationship to you?
Academic information:
What are you planning on majoring in?*
If you don't yet know you may enter Undecided, or list more than one major
What is your dream job, or what do you hope your college degree does for you?
What semester do you plan on starting classes at UWA?*

Spring 2024Summer 2024Fall 2024Already enrolled
Are you planning on graduating from UWA with a bachelor's degree?*

YesNo, I am majoring in the Nursing Associates Degree or Industrial Maintenance Associates Degree at UWANo, I plan on transferring at some point
Did you earn any college credit through AP or dual enrollment while you were in high school?
# of credits completed
Did you earn any college credit through AP or dual enrollment while you were in high school?
Please list the classes you are hoping to get a passing AP score on, or have earned college credit for.
Are you transferring from another college?*

YesNo
If you are a transfer student, what other colleges have you attended?
If you are a transfer student, how many semesters have you spent at other institutions?
Assessment of needs:
Please answer "Yes" to all that apply to your feelings about college at UWA.

I am concerned about:
Meeting people who I have something in common with.*

YesNo
Being homesick.*

YesNo
Having enough money to pay for college.*

YesNo
Getting good grades.*

YesNo
Getting/staying motivated to study.*

YesNo
Finding time to study and/or managing my time.*

YesNo
Having good enough study skills to get the grades I want.*

YesNo
Work or family obligations/responsibilities affecting my grades.*

YesNo
Finding a major/career I am interested in.*

YesNo
Please check this box if you have/will have a documented disability on file with the Disability Services office at UWA.

Yes, I have a documented disability and require ADA accommodations
Other things you are concerned about:
Is there anything else you would like us to know about your family situation, academics, health, or other issues?
Would you be interested in being contacted by a current SSS student who could share their knowledge of UWA and answer any questions you have?*

Yes, by textYes, by emailYes, by text or emailYes, by phoneNo
By signing below, you attest that all of the information is accurate and true. You also authorize Student Support Services to retrieve all relevant information to verify eligibility for participation, including admissions, academic, and financial data from all the necessary UWA departments. Please sign your full name below:
Signature*

Clear
Today's Date*
EG. xx/xx/2023
Problems submitting online? Please email Andrea Farquhar at afarquhar@uwa.edu to request a printable version of the application.
Should be Empty:

SSS Scholars Program* Application: