SSS Interest Form

SSS Interest Form

Last Name *

First Name *

Middle Name

Student Number (A#)

Cell Phone Number

Email Address

Date of Birth *

Please check all that apply:

U.S. Citizen or Permanent Resident

First Generation (Neither parent graduated from a 4 year college/university)

Low Income (Receiving Pell Grant)

Documented Disability

Previous TRIO program (Upward Bound, Talent Search, EOC)

Your signature indicates that the information provided above is true and gives Wallace State TRIO/SSS authorization to access your Financial Aid information including FAFSA and Admission records through the WSCC Financial Aid office.

Signature:

Signature Type: SMS Start Over

After validation, the cell phone number will become part of the electronic signature.

Cell Phone Number:

Enter characters above to send message.

Funded by the U.S. Department of Education