TRIO/Student Support Services

TRIO Information Request

Please answer all questions before submitting this form if you would like to receive more information about the TRIO Program at Cleveland State University.

Last Name *

First Name *

CSU ID *

Cell/Phone Number *

Email Address *

High School Graduation Date *

Example: May 2017

Last School or College/University of Attendance *

Example: John Hay High School, Cuyahoga Community College, GED, etc.

Eligibility Requirements *

	Yes	No	Unsure
Has either of your parents/guardians received a Bachelor's Degree? *	Has either of your parents/guardians received a Bachelor's Degree? - Yes	Has either of your parents/guardians received a Bachelor's Degree? - No	Has either of your parents/guardians received a Bachelor's Degree? - Unsure
Are you eligible for the Federal Pell Grant? *	Are you eligible for the Federal Pell Grant? - Yes	Are you eligible for the Federal Pell Grant? - No	Are you eligible for the Federal Pell Grant? - Unsure
Are you enrolled full time or accepted for enrollment at Cleveland State University? *	Are you enrolled full time or accepted for enrollment at Cleveland State University? - Yes	Are you enrolled full time or accepted for enrollment at Cleveland State University? - No	Are you enrolled full time or accepted for enrollment at Cleveland State University? - Unsure
Are you a U.S. citizen and/or legal permanent resident? *	Are you a U.S. citizen and/or legal permanent resident? - Yes	Are you a U.S. citizen and/or legal permanent resident? - No	Are you a U.S. citizen and/or legal permanent resident? - Unsure

Leave this field blank