TRiO Image
  • Lourdes University’s TRiO program is committed to providing students with personal attention to their academic, cultural and social needs.
  • Do you live on campus? * Required
  • Can we text you? * Required
  • Martial Status * Required
  • Veteran * Required
  • Eligibility Criteria (mark all that apply) * Required
  • Qualifying income level chart
  • Student Income Verification Checklist

  • Are you receiving financial aid for the current year? * Required
  • Check all that apply:
  • Documentation of Low Income Eligibility (need at least one) * Required
  • I certify that my taxable income for 2016 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.
  • I would like to learn more about my individual learning style. * Required
  • I would like to manage my time more efficiently. * Required
  • I would like to become a better test taker. * Required
  • I am interested in academic support/tutoring. * Required
  • I need to improve my study habits and skills. * Required
  • I need to improve my writing skills. * Required
  • I need to improve my math skills. * Required
  • I need to improve my reading skills. * Required
  • I am confused about where to start in choosing a career path. * Required
  • I want to learn which careers typically match my skills, interests, and personality traits. * Required
  • I am distracted by personal matters to the point that I am having trouble studying/keeping up with assignments. * Required
  • I feel uncomfortable communicating with professors/instructors, staff, and other students. * Required
  • I would like to improve my technology/computer skills. * Required
  • I need assistance with the financial aid process. * Required
  • I would like to learn about disability services on campus. * Required
  • I would like to receive academic advising to prepare me for entry into my major. * Required
  • I need personal support and encouragement. * Required
  • I would like to learn more about cultural diversity. * Required
  • I would like to attend cultural activities e.g., museums, theater. * Required
  • I would like to participate in activities that benefit others. * Required
  • I would like to develop more leadership skills. * Required
  • VERIFICATION AND RELEASE INFORMATION

  • 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.
  • Permission to contact professors/advisor: * Required
  • Permission to release name for recognition (scholarships, etc.): * Required
  • Permission to take my picture and use for recognition and advertising: * Required
  • 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.
  • *
  • This field is for validation purposes and should be left unchanged.