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: Simple    Start Over
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Signature: (Type in your full name)
I agree to the terms included.

 

“100% funded by the U.S. Department of Education ($355,073.00 annually)”