If you are interested in joining either the SSS or STEM program, please fill out the application below. If you would prefer to fill out the application form personally, the link is provided below. All application that are filled out manually can be e-mailed to j.wilsonbyrd@sscok.edu.

Applications are processed as soon as possible.

    SSS Application

    Choose which program you are applying to (required).


    STEM Student Support Services Application

    Student Support Services Application










    Male
    Female




    Yes
    No


    Yes
    No


    Yes
    No


    Hispanic
    Black or African American
    Asian
    White
    American Indian/Alaskan Native
    Native Hawaiian or Islander


    Full-time
    Three-quarter time
    Half-time
    Less than half-time


    Graduate and transfer
    Take classes personal
    Graduate and work
    Transfer without graduating



    Yes
    No


    Yes
    No

    FOR FINANCIAL AID YOU WILL BE CONSIDERED EITHER INDEPENDENT OF OR DEPENDENT ON THE INCOME EARNED BY YOUR
    PARENT/S OR LEGAL GUARDIAN/S. YOU ARE CONSIDERED INDEPENDENT ONLY IF ANY OF THE FOLLOWING APPLY:
    1. YOU ARE 24 YEARS OF AGE BY JANUARY 1ST OF THE YEAR YOU ARE APPLYING FOR AID
    2. YOU HAVE CHILDREN OR OTHERS WHOM YOU CLAIM AS LEGAL DEPENDENTS
    3. YOU ARE AN ACTIVE DUTY VETERAN
    4. YOU ARE OR HAVE BEEN A “WARD OF THE STATE"

    **If you are DEPENDENT, a completed Income Verification Form will be required of you and your legal guardian.




    IF THE REQUESTED FINANCIAL INFORMATION IS NOT PROVIDED ON THIS FORM OR THE INCOME VERIFICATION
    SHEET, YOUR APPLICATION IS CONSIDERED INCOMPLETE AND WILL NOT BE PROCESSED UNITL THE APPROPRIATE
    INFORMATION IS PROVIDED. **


    I am aware that there are two Student Support Services programs on campus. I understand that, although I can apply to both programs,
    I am only permitted to be served by one program. Once accepted into a program, I acknowledge that I should receive services from that
    program. I cannot be a participant in both programs.











    A quiet place to study
    Completing the FAFSA
    Discovering my preferred learning style
    Study skills help
    Tutoring in


    Transferring to 4-year institutions
    Adjusting to college policies and procedures
    Participating in an academic support system
    Class scheduling/registration
    Career planning
    Choosing a major
    Financial literacy/money management
    Other



    Student Support Services
    Upward Bound
    FOCUS
    NASNTI


    Testing Services
    Academic Clubs/Honor Societies
    Work study/on campus jobs
    Workforce and/or Employment Readiness
    Disability Services
    ACT, Dept, Math, Accuplacer preparation

    THIS APPLICATION, ACADEMIC TRANSCRIPTS AND TESTING SCORES WILL BE USED TO DETERMINE YOUR ELIGIBILITY TO
    PARTICIPATE IN THE TRADITIONAL SSS TRIO PROGRAM. APPLICATIONS WITH MISSING INFORMATION WILL NOT BE
    REVIEWED
    . WE WILL NOTIFY YOU TO SCHEDULE AN INTAKE INTERVIEW. IF YOU CANNOT ATTEND THAT APPOINTMENT YOU
    WILL NEED TO RESCHEDULE. IF BOTH APPOINTMENTS ARE MISSED, YOUR APPLICATION WILL NOT BE REVIEWED AND YOU
    WILL NOT BE CONSIDERED FOR ENROLLMENT IN THE PROGRAM.

    Application Acknowledgement and Release of Information Agreement: I certify that the information I have
    provided on this application is, to the best of my knowledge, true and correct. Further, I authorize the Student Support
    Services Program/professional personnel to receive and/or release my records including, but not limited to, transcripts,
    financial aid documentation (ie. FAFSA, ISIR, SAP, default information, scholarships, unmet need) academic plans, class
    schedules, probationary/suspension information, test scores, and other academic records/materials pertinent to my
    participation, including postsecondary information from the National Student Clearinghouse. I understand that my records
    are protected under State and Federal Confidentiality regulations. These records will be used internally for evaluating the
    need for program services, setting academic goals and measuring progress toward meeting goals. This information is
    required by law to meet U.S. Department of Education (the federal government grant funding agency**) regulations for
    the Student Support Services Program. Although this release may be revoked upon my written request, I agree that it shall
    be valid throughout my participation in the Student Support Services Program and beyond for verification of postsecondary
    enrollment, academic progress, graduation, and transfer.



    Income Verification




    I confirm, to the best of my knowledge, that the above listed information for my 2019 Annual Taxable Income is accurate.




    Updated 3/29/2021