Write Your Own Story




Thank you for your interest in the TRIO Student Support Services - STAR Program. The information requested below documents your eligibility and establishes your personal record. 

To make your application complete, students MUST submit the first two pages of their and/or their parents’ IRS tax form 1040. 

If yes, please also contact Disability Services (ext. 1654) for information about registration and support services.
If yes, please also contact Office of Adult Student Services (ext. 1257) for information about registration.
(include self)
CERTIFICATION STATEMENT - I understand that my enrollment in the Student Support Services Program is contingent upon verification of my income level, first generation status, and enrollment capacity. The federal government requires that TRIO SSS have on file documentation of taxable income, such as federal tax forms for all students admitted to the program. I authorize the TRIO Student Support Services – STAR Program staff to: Gather personal, financial and academic information (including Social Security Number) to ascertain program eligibility. Release information to the U.S. Department of Education as required for grant reporting. Use my name, photo, or information about me in any SSS and Bloomfield College media releases. Communicate verbally or otherwise with staff/faculty on my behalf.
I understand that by typing my first and last name it constitutes my electronic signature.