College Programs Application - SSS

Thank you for your interest in our CAEO's Campus based program! Please complete this application as thoroughly as possible. You cannot save and restart this application.  You may want to review the included items, take some time to make notes and gather the required documents, and then return to submit your application. If you have any questions, please call our office at (702) 774-4200.

Step 1: Please answer the following questions about yourself.
First Name: *
Middle Name:
Last Name *
Street Address: *
Apt #:
Permanent City: *
Permanent State: *
Permanent Zip: *
Permanent Phone: *
Preferred Contact Method: *
Email Address: *
NSHE ID Number: *
Date of Birth: *
Hispanic or Latino/a/x?:
American Indian::
Alaskan Native:
Asian:
Black:
African American:
Native Hawaiian:
Other Pacific Islander:
White:
Gender:
U.S. Citizen: *
Permanent Resident A-Number:
Parent Name: *
Parent Email: *
 

Step 2: Please answer the following questions about parents and about yourself.
Has your mother received/earned a 4-year college (i.e. bachelor's) degree? *
Has your father received/earned a 4-year college (i.e. bachelor's) degree? *
Which parent did you regularly reside with and receive support from during your childhood (i.e., until you were 18 years old)? *
 

Step 3: Please answer the following questions about yourself.
a. Are you married and not separated? *
b. Do you have children who receive more than half of their support from you? *
c. Do you have dependents (other than children or a spouse) who live with you and receive more than half of their support from you? *
e. Are you a veteran of the U.S. armed forces? *
f. At any time since you turned age13, were both of your parents deceased, were you in foster care, or were you a ward or dependent of the court? *
d. Are you currently serving on active duty in th U.S. armed forces for purposes other than training? *
g. Are you (or were you immediately prior to reaching the age of 18) an emancipated minor or in a legal guardianship as determined by a court? *
h. Are you an unaccompanied youth who is homeless or self-supporting and at risk of being homeless? *
 

Step 4: You must answer the following questions about yourself if you are at least 24 years old (or will be by December 31 of the current academic year) or you answered YES to any question in Step 3.

           Your parent(s) must answer the following questions about themselves if you are less than 24 years old after December 31 of the current academic year and you answered NO to all questions in Step 3.
a. What is the total number of persons (including you) in your family? *
b. What was your family's taxable (not total) income from the last calendar year? Then, provide the requested income information. *
Requested income *
 

Step 5: Please answer the following questions about yourself.
a. If you are currently enrolled at UNLV, are you at risk of failing any of your courses (e.g. have a 'C' grade or below)? *
b. Are you interested in majoring in STEM or Health Sciences? (Answer only if your current major is NOT in STEM or Health Sciences) *
c. How interested are you in pursuing a Ph.D. after you finish your bachelor's degree? *
d. Are you registered with the UNLV Disability Resources Center (DRC) as a student who is experiencing a disability that is formally recognized by UNLV? *
 

Step 6: Please answer the following questions about your interest in select services that CAEO's campus-based programs provide. How interested are you in:
a. ...receiving one-on-one tutoring? *
b. ...being mentored by a more advanced student? *
c. ...becoming a trained mentor to a less advanced student? *
d. ...conducting research under the guidance of a UNLV professor? *
e. ...completing an internship with a UNLV industry partner? *
f. ...accessing opportunities for need-based grants and scholarships? *
g. ...receiving career counseling? *
h. ...receiving assistance with selecting courses? *
i. ...receiving financial-aid counseling? *
j. ...receiving financial-literacy information? *
 

Step 7: Please answer the following questions.

 a. How did you learn about the programs?
Class or group presentation
Recommendation from a professor
Letter from program staff
Recommendation from a current program participant
E-mail message from program staff
Other
If "Other", please indicate:

 b. Please answer the following questions: Were you a participant in...?
a. ...UNLV's TRIO Upward Bound program while you attended high school? *
b. ...UNLV's TRIO Talent Search program while you attended middle or high school? *
c. ... UNLV's TRIO Educational Opportunity Center (a.k.a., Adult Educational Services) program? *
d. ... UNLV's GEAR UP program while you attended middle or high school? *
e. ...a TRIO Student Support Services program while attending another college? *

 c. Please review all the information for accuracy.
Have you reviewed for accuracy all the information you entered in this form? *
 

Step 8: Please be aware that you will not be able to change any of your responses after submit the application.

By signing this application, I attest that all the information on this application is true. Moreover, I authorize the release of the student's official academic records to the Center for Academic Enrichment and Outreach (CAEO) at the University of Nevada, Las Vegas, understanding that the information in these records will be used only to assess the student's need for TRIO or AANAPISI program services; discern the student's educational progress; evaluate the effectiveness of program activities; and fulfill program-reporting requirements. Finally, I authorize CAEO to use the student's name, statements, and likeness, without charge, for promotional purposes in CAEO publications, advertising, video, and other formats.
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I agree to the terms included.