

Thank you for taking the time to submit a TRIO nomination. Our team will reach out directly to the student you nominated to share information about TRIO, answer any questions, and invite them to apply if they are interested and eligible.
Student Last Name *
Student School ID *
Referred by: *
TRIO Student Support Services must document academic need when selecting participants. Institutional data provides many indicators; however, faculty and staff nominations help supplement this information and allow the program to conduct personalized outreach to students who may benefit from TRIO services. Please indicate to the best of your ability any factors that suggest the student may benefit from additional academic support. Select any indicators that apply:
Academic Need No Response/Unknown Low high school grades Out of the academic pipeline for 5 or more years Other Limited English proficiency Lack of educational and/or career goals Lack of academic preparedness Lack of academic preparedness for college level course work Need for academic support to raise grade(s) in required course(s)/academic major Need for academic support to raise grade(s) Low admission test scores Predictive indicator Diagnostic tests Academic proficient tests Low college grades High school equivalency Failing grades
Academic Need No Response/Unknown Low high school grades Out of the academic pipeline for 5 or more years Other Limited English proficiency Lack of educational and/or career goals Lack of academic preparedness Lack of academic preparedness for college level course work Need for academic support to raise grade(s) in required course(s)/academic major Need for academic support to raise grade(s) Low admission test scores Predictive indicator Diagnostic tests Academic proficient tests Low college grades High school equivalency Failing grades
Academic Need No Response/Unknown Low high school grades Out of the academic pipeline for 5 or more years Other Limited English proficiency Lack of educational and/or career goals Lack of academic preparedness Lack of academic preparedness for college level course work Need for academic support to raise grade(s) in required course(s)/academic major Need for academic support to raise grade(s) Low admission test scores Predictive indicator Diagnostic tests Academic proficient tests Low college grades High school equivalency Failing grades
Academic Need No Response/Unknown Low high school grades Out of the academic pipeline for 5 or more years Other Limited English proficiency Lack of educational and/or career goals Lack of academic preparedness Lack of academic preparedness for college level course work Need for academic support to raise grade(s) in required course(s)/academic major Need for academic support to raise grade(s) Low admission test scores Predictive indicator Diagnostic tests Academic proficient tests Low college grades High school equivalency Failing grades
Academic Need No Response/Unknown Low high school grades Out of the academic pipeline for 5 or more years Other Limited English proficiency Lack of educational and/or career goals Lack of academic preparedness Lack of academic preparedness for college level course work Need for academic support to raise grade(s) in required course(s)/academic major Need for academic support to raise grade(s) Low admission test scores Predictive indicator Diagnostic tests Academic proficient tests Low college grades High school equivalency Failing grades
Academic Need No Response/Unknown Low high school grades Out of the academic pipeline for 5 or more years Other Limited English proficiency Lack of educational and/or career goals Lack of academic preparedness Lack of academic preparedness for college level course work Need for academic support to raise grade(s) in required course(s)/academic major Need for academic support to raise grade(s) Low admission test scores Predictive indicator Diagnostic tests Academic proficient tests Low college grades High school equivalency Failing grades
Academic Need No Response/Unknown Low high school grades Out of the academic pipeline for 5 or more years Other Limited English proficiency Lack of educational and/or career goals Lack of academic preparedness Lack of academic preparedness for college level course work Need for academic support to raise grade(s) in required course(s)/academic major Need for academic support to raise grade(s) Low admission test scores Predictive indicator Diagnostic tests Academic proficient tests Low college grades High school equivalency Failing grades
Academic Need No Response/Unknown Low high school grades Out of the academic pipeline for 5 or more years Other Limited English proficiency Lack of educational and/or career goals Lack of academic preparedness Lack of academic preparedness for college level course work Need for academic support to raise grade(s) in required course(s)/academic major Need for academic support to raise grade(s) Low admission test scores Predictive indicator Diagnostic tests Academic proficient tests Low college grades High school equivalency Failing grades
If you selected Other/No Response/Unknown, please explain