TRIO STEM Application

The Citrus College TRIO STEM student support services program

is designed to assist first-generation, low-income, and/or disabled students majoring in STEM and Health Sciences by offering a variety of services tailored to meet their individual needs.

Students who participate will:

• Receive personalized and regular support from TRIO facilitators

• Have access to personalized math and science tutoring

• Opportunities to learn how to finance college and minimize student debt

• Be part of a motivated cohort of peers working towards degree/certificate completion

QUESTIONS?

Email trio@citruscollege.edu

or contact a TRIO facilitator

Karina Quevedo · senior TRIO facilitator

kquevedo@citruscollege.edu · (626) 857-4007

Evelyn R. Uribe · part-time TRIO facilitator

euribe@citruscollege.edu · (626) 857-4026

SUBSCRIBE & FOLLOW

Stay updated on STEM events, opportunities, and scholarships.

Subscribe: linktr.ee/stematcitruscollege

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STEM TRiO eligibility:

• Have a declared STEM (science, technology, engineering, and mathematics) or health sciences (dental assist, pre-allied health, nursing, etc.) major

• Identify with at least one of the following:

First-generation college student
Low-income
Registered with DSPS

• Must be a U.S. citizen or permanent resident

• Willing to meet regularly with program staff and participate in project activities.

STUDENT INFORMATION

First and Last Name

Citrus Student ID

Citizenship

Citrus College Email

Personal Email

Cell Phone Number

Phone

Can we send text messages to the cell phone number you provided?

Yes

Residential Street Address

City and State

Zip Code

Date of birth

Gender

Do you have children?

Yes

Are you currently working?

Yes

Do you identify as Hispanic?

Yes

Racial-Ethnic Background (Check all that apply)

American Indian or Alaska Native - A person having origins in any of the original peoples of North and South America (including Central America) and who maintains tribal affiliation or community attachment

Asian - A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent including, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, & Vietnam

Black or African American - A person having origins in any of the Black racial groups of Africa

Native Hawaiian or Other Pacific Islander -A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands

White - A person having origins in any of the original peoples of Europe, the Middle East, or North Africa

Emergency Contact

Name/Relationship to you/Phone Number

ACADEMIC INFORMATION

Please indicate the year you obtained a high school diploma, GED, or Other

Last High School Attended:

High School and City

Have you attended other colleges or universities?

Yes

Have you earned an AA/AS?

Yes

Have you earned a BA/BS?

Yes

What is your current Citrus College major?

What is your Citrus College GPA?

ELIGIBILITY

Has Parent #1 graduated from college with a 4-year degree?

Yes

N/A

Has Parent #2 graduated from college with a 4-year degree?

Yes

N/A

Before the age of 18, with whom did you reside?

Parent #1

Parent #2

Other

Have you applied for financial aid?

Yes

Do you have a documented disability and are you registered with DSPS at Citrus College?

Yes

EDUCATIONAL GOALS

What degree are you seeking at Citrus College?

Anticipated last semester at Citrus College?

Example: Spring 2025

Do you intend to transfer to a 4-year institution?

Yes

What is your anticipated transfer major?

FINANCIAL INFORMATION

Are you 24 years of age or older?

Yes

As of today, are you married? (If you are separated, but not divorced also answer “Yes”)

Yes

Are you currently serving on active duty in the U.S. Armed Forces for purposes other than training?

Yes

Are you a Veteran of the U.S. Armed Forces?

Yes

Do you have children who will receive more than half of their support from you?

Yes

Do you have dependents (other than your children or spouse) who will live with you and who receive more than half of their support from you?

Yes

At any time since you turned age 13, were both your parents deceased, were you in foster care or were you a dependent of the court?

Yes

Are you or were you an emancipated minor as determined by a court of law?

Yes

Are you or were you in legal guardianship as determined by a court of law?

Yes

Within the past two years, were you determined to be an unaccompanied youth who was homeless OR were self-supporting and at risk of being homeless?

Yes

Independent student vs. Dependent student

• If you answered YES to any of the questions in the Financial Information section above, you're considered an Independent student and will need to provide your own tax return information below.

• If you answered NO to any of the questions in the Financial Information section above, you're considered a Dependent student and will need to provide your parent or guardian tax return information below.

What is the total number of persons (including you) in your family?

What tax year is the filed tax return you're using for this application?

We accept tax returns from up to two years prior.

What is the Taxable Income?

You can find this information on:

IRS Form 1040 & 1040SR

Tax return: Line 15

SHORT ANSWER QUESTIONS

What are your educational goals? What motivates you to successfully reach these goals?

80 - 150 words required

What personal or academic challenges must you overcome in order to reach your educational goals?

80 - 150 words required

Is there anything you think the project staff may need to know about you that would help them better assist you? If yes, please explain.

80 - 150 words required

Check all areas in which you feel SSS staff may be able to assist you:

Academic Guidance - Get advice to stay on track to graduate and transfer on time.

Tutoring - Receive personal one-on-one and online tutoring in STEM and health science subject areas at no cost to you.

Financial and Economic Literacy - Learn about managing a budget and making wise financial decisions.

Learning Styles and Study/Test Taking Skills - Assistance in identifying your style of learning and some strategies to study and take tests successfully.

Graduation & Transfer to 4 Year College -Receive assistance in graduation from Citrus College & transfer to college/university.

Financial Aid Information & Assistance Applying - Assistance completing FAFSA annually. Learn about scholarships & other financial aid options.

REQUIRED DOCUMENTS

Submit the following files

Before uploading your documents, view the Steps to Retrieving Required Application Documents tab on the main TRIO webpage.

• Copy of your Financial Aid Award Overview

• Unofficial transcripts from all colleges you have attended

• Copy of your Comprehensive Student Educational Plan (CSEP)

Drop your files here

AUTHORIZATION OF INFORMATION/STATEMENT OF AUTHENTICITY

By submitting this application, I attest that the information I have provided is true and correct to the best of my knowledge. I attest that the documents I have presented for verification of eligibility are genuine and relate to me. I am aware that any false documents in connection with eligibility will be cause for my dismissal from the Student Support Services program.

In accordance with the Privacy Act of 1974 (Public Law No. 93-579, 5 U.S.C. 552a), you are hereby notified that the Department of Education is authorized to collect information to implement the Student Support Services Program under Title IV of the Higher Education Act of 1965, as amended (Pub. Law 102-325, Sec. 402D). In accordance with this authority, the Department receives and maintains personal information on participants in the Student Support Services program. The principal purpose for collecting this information is to administer the program, including tracking and evaluating participant progress. Providing the information on this form, including a social security number (SSN) is voluntary; failure to disclose a SSN will not result in the denial of any right, benefit or privilege to which the participant is entitled. The information that is collected on this form will be retained in the program files and may be released to other Department officials in the performance of their official duties.

Date of Application

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TRIO STEM﻿ Application

STUDENT INFORMATION

ACADEMIC INFORMATION

ELIGIBILITY

EDUCATIONAL GOALS

FINANCIAL INFORMATION

SHORT ANSWER QUESTIONS

REQUIRED DOCUMENTS

AUTHORIZATION OF INFORMATION/STATEMENT OF AUTHENTICITY

TRIO STEM Application