Thank you for your interest in our TRiO Student Support Services (SSS) program at Worcester State University (WSU)!

Important:

Please review the application questions before you begin. Gather any information and/or documentation necessary because once you begin, you cannot save and restart this application.  If you have any questions, please call our office at (508) 929-8014.

Eligibility Guidelines

Students are eligible to apply for the TRiO SSS program at WSU if they meet the following U.S. Department of Education guidelines:

  • Are enrolled in a WSU undergraduate program or accepted for enrollment at WSU (must be working toward first bachelor's degree)
  • Are a citizen of the United States or have permanent residency
  • Are in need of academic support

Must meet at least one of the following criteria:

  • Neither parent graduated from a four-year college or university
  • Meet government income guidelines based on taxable income
  • Have a documented physical, mental, learning, or ADD/ADHD disability
Student Information:
First Name *
Last Name *
Middle Name
School ID *
WSU Email: *
Cell Phone Number *
Date of Birth *
Address *
Address 2
City *
State *
Zip *
Gender *
Are you a U.S. Citizen or Resident? *
If applicable, please add your A-Number
Ethnicity: *
Race, White *
Race, American Indian or Alaskan Native *
Race, Asian *
Race, Black or African American *
Race, Hispanic *
Race, Hawaiian or other Native to Pacific Island *
Are there any additional languages you speak: *
Do you have a documented disability? *
College Grade Level: *
Do you have previous TRiO experience: *
Were you referred to TRiO SSS? *
If yes to question above, please provide the name of the person or department that referred you.
Academic Information:
Major: *
Minor 1:
Minor 2:
Concentration:
How many classes are you taking?
Are you a commuter or resident? *
Are you a student athlete? *
Are you in the honors program? *
Family Information:
Parents Educational Level: *
How many people in your household at home?
Family Income Range:
Most Recent Student Aid Report (SAR) (This document can be located in your FAFSA account and/or your email communication with FAFSA)
Photo Release:
Photo Release Opt In/Out *

 

 

 

TRiO Student Support Services (SSS) at Worcester State University (WSU) Photo Release:

 

*Please Read Carefully*

 

By opting in, I hereby grant Worcester State University the right and license to use my name, voice, image/appearance, comments, and demographic information such as age, hometown and/or major, in Worcester State University’s materials for internal and external audiences. These materials include but are not limited to: photographs, advertisements, brochures, view books, news releases, magazines, newspapers, radio, video and web sites.
Sign and Submit:
Applicant Signature *
Please select a signature verification type.

Certification:

I certify that any information which I have provided is true and correct to the best of my knowledge. I understand that TRiO Student Support Services (SSS) staff will use the data provided on this application form to assist in assessing any academic and/or career planning needs and that all of the information will be used in the strictest confidence. 

I also understand that TRiO SSS staff will use this information to verify my eligibility for participation in the program.

By signing this form, I authorize TRiO SSS to obtain any and all financial and academic information and/or disability documentation necessary for processing and on-going evaluation of my academic pursuits. I also understand that the TRiO SSS staff will assist me in achieving my academic goals only if I fulfill my obligations and that failure to meet my responsibilities as required can result in suspension or termination from the program.