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TRiO Student Support Services Application

  • Lourdes University’s TRiO program is committed to providing students with personal attention to their academic, cultural and social needs.
  • Qualifying income level chart
  • Student Income Verification Checklist

  • I certify that my taxable income for 2022 was below the qualifying income levels Qualifying income level chart
  • Note: This is only to be used for students with no other way of documenting their low income eligibility (e.g., did not file taxes, did not receive state assistance, and did not apply for financial aid)
  • Student Needs Assessment

  • This inventory will help in assessing your needs for services which are offered by the TRiO Program. Please check YES or NO in response to each of the following questions.

  • TRiO/Student Support Services is a program designed to help you graduate. The information provided is confidential and will help determine eligibility for the TRiO program. Discrimination is prohibited on the basis of race, gender, color, national origin, religion, age, disability, marital or parental status, or sexual orientation.

    I hereby authorize TRiO/Student Support Services to share any information pertinent to my participation in the program. This information includes, but is not limited to, financial aid information, standardized test scores, transcripts, and grade reports. I also verify that the information provided on this form is correct and complete to the best of my knowledge.
  • Agreement & Signature

  • I understand that I am not accepted into the TRiO program or eligible for services until my application file is complete and I have been approved for admission per a letter from the TRiO Director.

    I understand that I must meet participant requirements in order to maintain my TRiO membership.

    By including my signature below I certify that all of the information within this form is accurate.
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