Submit Your Application

SJC - TRIO STEM Application

Thank you for your interest in our Student Support Services program! Please complete this application as thoroughly as possible. You cannot save and restart this application. You may want to review the included items, take some time to make notes, and then return to submit your application. If you have any questions, please call our office at (505) 566-3147.

Personal Information:

SJC ID# *

Last Name: *

First Name: *

Middle Name:

Date of Birth: *

Gender: *

Marital Status: *

SA Ethnicity *

Are you a veteran? *

Address: *

Address 2:

City: *

State: *

Zip Code: *

Home Phone

Cell Phone Number: *

Describe what TRIO services you are interested in: *

How did you hear about TRIO? *

Eligibility Information:

SJC Email Address: *

Do you have a documented disability?

What is your overall GPA? *

Father/Guardian 1 Educational Level: *

Mother/Guardian 2 Education Level: *

How many people in your household at home? *

Family Income Range: *

Please check all that apply:

I am receiving Federal Aid (Pell Grant, SEOG, Work Study, Subsidized Loan, Unsubsidized Loan, or Veteran's)

I am receiving additional funding (Scholarships, DVR, or other)

I completed my FAFSA

If receiving funding, please specify:

Did you graduate High School? *

Sign and Submit:

Applicant Signature *

Please select a signature verification type.