Thank you for your interest in SSS-TRiO Teachers Program! As you begin the application, please be mindful that you will have to provide demographic, financial, and educational information. We ask that you answer as honestly and accurately as possible. This information is used to determine eligibility for our federally funded grant through the Department of Education. If you have any questions about the application, you may email the coordinator, Berenice Mosqueda at Mosqueda_Berenice@sccollege.edu. OR, please call our office at (714) 628-5032.

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General Information:

First Name *

Middle Name

Last Name *

Date of Birth *

School ID *

Local Address *

Local City *

Local State *

Local Zip *

Contact Phone Number *

If You Would NOT Like To Receive Text Messages, Please Click The Box

Are you interested in being a future teacher? *

Demographic Information:

Choose which applies *

Are You a First-Generation Student? *

First Semester Enrolled at SCC (e.g. Fall 2021) *

Ethnicity *

Gender *

Preferred Gender Pronouns (e.g. She/Her, He/Him, They/Them)

Education Information:

Highest Level of Education Completed? *

If you have attended another college/university, which school did you attend?

Academic Need: Please Choose One *

What is Your Educational Goal? *

Check Any Programs You Are A Part Of (Answers Are Confidential):

EOPS/CARE/CalWORKS

CAMP

DSPS

Guardian Scholars

Honors

TRIO-SSS

Veterans

Supplemental Questions:

Are there any academic obstacles you are anticipating or currently facing in college?

How can SSS-TRIO Teachers help you achieve your goals in pursuing a career in teaching? (services: tutoring, academic coaching, academic counseling, study space, and/or school supplies) *

Financial Information:

Certification: You certify that the responses on this form are accurate and complete to the bet of your knowledge and that any misrepresentation may be cause for denial or cancellation of admission to the TRIO-Teachers program. You understand that you may be asked to provide additional income documentation if admitted into the SSS-TRIO Future Teachers program.

Verification: I understand SSS-TRIO Teachers Future Teachers Program will have access student's financial aid award for verification.

What Is Your Household Size? *

What Is The Total Income For Your Household? *

Did you apply for FAFSA this Academic School Year? *

Confirm Your Email: This will be the primary communication method we use *

Sign and Submit:

Applicant Signature *

Signature Type: Simple Start Over

Signature: (Type in your full name)

I agree to the terms included.