ETS English Application 24-25

EDUCATIONAL TALENT SEARCH
WHAT IS EDUCATIONAL TALENT SEARCH?

Educational Talent Search (ETS) is a federally funded program offered through Diablo Valley College in partnership with Mt. Diablo Unified School District. Our program aims to provide students and families with information for a college bound pathway & to empower students to attend the college/university of their choice after high school graduation. (Total Annual Budget $381,327)
WHAT TYPE OF SERVICES DOES ETS PROVIDE?

ETS offers the following services at zero cost to students who qualify:-Academic /Tutoring - Career Exploration- Financial Aid Literacy - Academic Advising- ACT/SAT Information - College Planning- Campus Tours - Summer Program
WHAT ARE THE ELIGIBILITY REQUIREMENTS?

The ETs program is available to middle & high school students enrolled in our 5 participating schools at the time of application: You must also meet at least one or more of the following criteria: a) First generation college student b) Income within federal guidelines c) Academic needs
WHERE IS EDUCATIONAL TALENT SEARCH LOCATED?

dvcets@dvc.edu Brenda Mora ETS Program Coordinator
Student Application/Information Section
Student Legal First Name:*
No nick names
Student Legal Last Name:*
No nick names
Date of Birth*

MonthDayYear
Date
Gender:*

MaleFemale
Self-Identify:
Pronouns:
She/Her, He/Him, They/Them
Student Phone Number*
Student's Non-School Email:*
Are you a US Citizen?*

YesNo
Social Security Number (SSN)
If not a US Citizen, are you a permanent resident?

YesNo
Permanent Resident Card Number (USCIS Number)
If not, are you in the process of becoming a permanent resident?

YesNo
Current School:*
Provide your school name here
Student ID#:*
Current Grade:*

6th7th8th9th10th11th12th
Please upload the most recent school transcript. It is not required for 6th-grade students.

Browse Files

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Are you currently enrolled in another outreach program? (ex. AVID/EAOP/UB/UB Math & Science/GEARUP/etc.)*

YesNoOther
Ethnicity: Check all that apply*

African American/BlackAmerican Indian/Alaska NativeAsian/Asian AmericanCaucasian/WhiteHispanic/LatinoNative Hawaiian/Other Pacific IslanderOther
Parent Application/Information Section
Parent 1/Guardian
Print Name:*
Legal First and Last Name
Contact Phone*
Email:*
Address*

Street Address

Apt. #

CityState / Province

Postal / Zip Code
Occupation:*
Job Title/unemployed/homemaker/Other: Please specify here
Parent 1/Guardian Education:*

Elementary/Middle School/Some High SchoolHigh School Diploma/GED2-year college degree4-year college degree
Parent 2/Guardian
Print Name:
Legal First and Last Name
Contact Phone:
Email:
Address

Street Address

Apt. #

CityState / Province

Postal / Zip Code
Occupation:
Parent 2/Guardian Education:

Elementary/Middle SchoolHigh School Diploma/GED2-year college degree4-year college degree
Student Resides with:*

One ParentBoth Parents
Language Preference:*
English/Spanish/Other: Please specify here
Does your child have a physical or learning disability:*

Yes (if yes, attach entire IEP/504 report)No
If yes, specify and attach IEP/504
Please attach IEP/504

Browse Files

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Note: All personal records or documentation will be held in strickest confidence by the staff of ETS, DVC and Contra Costa Community College District (consistent with the Federal Family Education Rights and Privacy Act of 1974, regulations and other laws) and will not be released to any other entity without my prior acknowledge and consent. This acknowledge will be effective for the duration of my child's participation in the program.
Needs Assessment 2024-2025

Please check the areas in which you need assistance:
Please check the areas where you need assistance (check all that apply)*

College AdmissionsCollege InformationChoosing a majorCampus visitsNote TakingSelf-AwarenessTutoringGrade ReviewsTime managementCourse selectionPaying for CollegeMoney ManagementStudy SkillsTest PrepLoan ForgivenessScholarshipsChoosing a career
Eligibility Certification: I/we the parent(s)/guardian(s) of the above named student had an Annual Taxable Income (fill in the blank) for 2024*
See Line 15 on the 2024 1040 Tax Return
Which supported (number of people) *
Including parents and student, how many people does this income support?
Does applying Student/Parent/Guardian receive any of the following: (Select all that apply):

Social Services Income
Do you have other children in grades 6th - 12th?*

YesNo
If yes, Name of Child 1:
Legal First and Last Name
School name of Child 1:
Please provide school name here
If yes, Name of Child 2:
Legal First and Last Name
School name of Child 2:
Please provide school name here
Participation Agreement and Release
Student Name:*
has my permission to participate in supervised online and in person activities educational, academic, social, cultural, college, career and other college matriculation services and field trips with the Contra Costa Community College District, Diablo Valley College ans Educational Talent Search staff. I realize that this will require my child to interact with and exchange information and images with staff in an online format i.e. Zoom, Loom, Google Classroom, Remind, TAWK, On Track, College Choices, CANVAS, UC Scout, Khan Academy and social mediaI will attend one Parent Workshop per year and understand that occasionally class release time is required for my child to receive in person services.
Parent/Guardian Initials:*
By providing Parent/Guardian Initials, you are agreeing to above statement
I/we do hereby give consent to DVC ETS (employees and agency) to render or seek necessary emergency medical treatment and assistance to the participant/my child. The participant, his/her parents or legally appointed guardian hereby agree to indemnify, hold harmless, release and forever discharge the DVC Educational Talent Search employees and/or agents from all claims and demands which the participant, his/her parents or legal guardian or the representatives or successors of them or any person may have against Contra Costa Community College District, DVC and its employees and agents by reason of acts, illness, or injury, or other consequences arising or resulting directly or indirectly from the participation of said minor in the aforementioned ETS activities.
Parent/Guardian Initials:*
By providing Parent/Guardian Initials, you are agreeing to above statement
Student Initials:*
By providing Student Initials, you are agreeing to above statement
I/we authorize the DVC ETS to obtain documents concerning my child’s education, which include: a copy of my child’s school transcript, test scores, ACT/SAT and school lunch program eligibility. I/we hereby give my permission for my child’s name, photograph, work, and/or statements for use by DVC ETS for promotional, publicity web pages, social media, brochures, newspaper, etc and for instructional purposes.
Parent/Guardian Initials:*
By providing Parent/Guardian Initials, you are agreeing to above statement
I do hereby give my college of attendance and National Student Clearinghouse permission to disclose my college enrollment status and degree attainment data to the CCCCD/DVC ETS staff for the purpose of tracking my college enrollment and completion. I authorize ETS to obtain information related to my application for receipt of student financial assistance (federal, state, or other) and a copy of my award notification from the financial aid office and college admission registration information.
Student Initials:*
By providing Student Initials, you are agreeing to above statement
I realize that I must meet with my ETS Advisor monthly in order to benefit from program services
Student Initials:*
By providing Student Initials, you are agreeing to above statement
Print Parent 1/Guardian Name:*
Legal First and Last Name
Parent/Guardian Signature*

Clear
Date*

MonthDayYear
Date
Parent 2 / Guardian Name:
Legal First and Last Name
Parent 2 / Guardian Signature

Clear
Date

MonthDayYear
Date
Student Name:*
Legal First and Last Name
Student Signature*

Clear
Date*

MonthDayYear
Date
STOP!

Please review your application before submitting and be sure the following is included:
- Parent and student has provided and signed legal first and last name
- Contact information including:
  - phone/cell
  - email addresses
- Ethnicity
- Annual Taxable Income and Number of people it supported
- Transcript and/or IEP/504, or Permanent Resident documents have been uploaded
Review Common Application Mistakes:

1. Misspelled first and last name

2. Misspelled email/Wrong phone numbers

3. Not including both parents/guardian information when checking box indicating residing with both parents/guardians

4. Transcript and/or IEP/504 or Permanent Resident docuements not uploaded

Any questions?

Follow up with your ETS Advisor:

ETS Advisors

DVCETS@DVC.edu

Ms. Brenda, bmendezmora@dvc.edu, 925-969-2010
Should be Empty:

EDUCATIONAL TALENT SEARCH

WHAT IS EDUCATIONAL TALENT SEARCH?

WHAT TYPE OF SERVICES DOES ETS PROVIDE?

WHAT ARE THE ELIGIBILITY REQUIREMENTS?

WHERE IS EDUCATIONAL TALENT SEARCH LOCATED?

Student Application/Information Section

Parent Application/Information Section

Parent 1/Guardian

Parent 2/Guardian

Needs Assessment 2024-2025

Participation Agreement and Release