Program Application
Welcome to SUNY Schenectady's TRIO Student Support Services program application. Please complete this application as thoroughly as possible. If you have any questions, please stop by our office in Elston Hall 328. 
General Information:
First Name *
Middle Initial
Last Name *
Preferred Name:
Student ID:
Date of Birth: *
Personal Email:
SUNY Schenectady Email:
Cell Phone Number: *
Personal Information:
Personal Information is used by the TRIO office to prepare summary data reports to the Federal government and other agencies. It will not be used in any way to determine your acceptance into TRIO Student Support Services.
Gender *
Please choose from the following racial/ethnic identities. You may select more than one.
American Indian or Alaskan Native *
Asian *
Black or African American *
Native Hawaiian or Other Pacific Islander *
Hispanic/Latino *
White *
Other
Academic Info:
Which support service most interests you? *
Eligibility Information:

Students are eligible to apply for TRIO Student Support Services at SUNY Schenectady if they meet at least one (1) of the following criteria.

Please check all that apply to you:

First Generation Student:
The parent(s)/legal guardian(s) that I regularly resided with prior to age 18 have not graduated with a Bachelor’s degree (4-year degree)

 Income Eligible:
I meet government income guidelines based on the

Accessibility Accommodations:
I have a documented physical, medical, psychological, or learning disability that is registered with the SUNY Schenectady ADA Transition Services Office.
Sign and Submit:
I hereby apply for services in the TRIO Student Support Services (SSS) program at SUNY Schenectady County
Community College (SUNY Schenectady). I certify that the information I have supplied on this form is true and accurate, to the best of my knowledge. I understand that the TRIO program can share and receive information from my educational benefit with other SUNY Schenectady offices, staff and faculty according to the Family Rights and Educational Privacy Act (FERPA) of 1974. I understand that my application does not indicate automatic acceptance into the program. I understand that I may withdraw from this program at any time. 
 
Applicant Signature: *
Please select a signature verification type.
___________________________________________________

Online applications can be submitted by clicking 'Submit Application' below.

Paper applications can be submitted in person to the
TRIO SSS Program Office - SUNY Schenectady County Community College
78 Washington Avenue - Elston Hall Room 328
Schenectady, NY 12305 

For more information, stop by our office, call us at 518-381-1465 or visit www.sunysccc.edu/trio