TRiO Student Support Services STEM Logo

Thank you for your interest in our TRiO 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 are a STEM major (in any Science, Technology, Engineering, or Math field) please fill out the STEM application instead.

The U.S. Department of Education funds the TRIO Student Support Services grant in the amount of $348,002 per year.

Student Information:
First Name *
Middle Name
Last Name *
Date of Birth: *
Student ID Number *
Address: *
Apt number (if applicable):
City: *
State: *
Zip Code: *
Cell Phone Number:
GRC Student Email Address: *
Personal email
What is the best way to reach you? *
Why do you want to join TRiO? *
Academic Information:
Major
What degree are you currently seeking at Green River College? *
Are you planning to transfer to a four-year college or university, or complete a BAS at Green River? *
Do you plan to transfer before or after you complete your degree at Green River College? *
How many credits are you currently taking? *
Please enter your current Green River GPA (if this is your first quarter, please enter 0):
Eligibility Criteria:
Citizenship Status: *
Did the parent(s)/guardian(s) who had custody of you as a child complete a bachelor's (4-year) degree? *
Parent/guardian(s) highest education level: *
Do you have a disability? *
Family Income Range: *
How many family members are included in your household? *
Are you currently in Running Start? *
Demographic Information:
Gender:
Pronouns:
Are you of Hispanic, Latino/a/x, or Spanish origin? *
Race* (Please select all that apply)
American Indian or Alaskan Native
Asian
Black or African American
Native Hawaiian or other Pacific Islander
White
What is the primary language you speak?
Are you a veteran of the United States Armed Forces?
Are you now, or have ever been, in foster care?
Are you currently homeless?
Do you have a constant resource for food and housing?
Do you have someone you can talk to in times of grief?
Marital Status: *
Please check if you have any children:
Support Needs:
How can our TRiO program best support your career and educational goals?* (Please check all that apply)
Academic advising
Career development/planning
Cultural/identity development
Financial aid support
Internship opportunities
Mentorship in the community/career field
Personal development
Personal financial literacy
Self-efficacy/advocacy
Scholarship search support
Study skills
Transfer planning
Tutoring
Sign and Submit: 

AFFIDAVIT, RELEASE OF INFORMATION, AND CONFIDENTIALITY STATEMENT:
I certify that the information provided on this application is true and complete to the best of my knowledge. I also agree to provide additional documentation upon request to verify the information reported.

I give TRiO-SSS staff permission to look at my college records (i.e. transcripts, financial aid applications & awards, COMPASS scores, College Student Inventory). I understand staff may consult with other GRC staff and faculty on a quarterly basis and that all of this information will be treated with confidentiality. I understand that this information is used to assist in the determination of my eligibility for the program and enhance the effectiveness of the program and services provided to me. I am aware that my eligibility and financial aid status will be reported to the U.S. Department of Education in accordance with the grant funding regulations.

The TRiO SSS staff will work to provide privacy for students participating in the program. In addition to the limits of confidentiality outlined above, the following waivers apply:

  • When a student discloses that s/he knows a child or elderly abuse
  • When a student discloses that s/he is a threat to self or others
  • When TRiO records are legally subpoenaed

If any of the above applies, I understand that TRiO SSS is legally required to report information to the appropriate authorities. My signature denotes my understanding of the TRiO SSS disclaimers outlined above.

Applicant Signature *
Signature Type: Simple    Start Over
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Signature: (Type in your full name)
I agree to the terms included.