PROGRAM APPLICATION

 

Thank you for your interest in our TRIO STEM3S 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 gather the required documents, and then return to submit your application.

If you have any questions, please call our office at (352) 395-5958 or email melody.graveen@sfcollege.edu

 
Section One: Student Information
First Name: *
Middle Name
Last Name: *
Date of Birth: *
What is your Santa Fe College ID number? *
Gender *
Address: *
Address 2:
City: *
State: *
Zip Code: *
Home Phone
Cell Phone Number: *
Email Address: *
May we send occasional TEXT MESSAGES with program information to you cell phone number? *

Racial/Ethnic Background

Please select all that apply.
Ethnicity: Hispanic or Latino? *
Race: American Indian or Alaskan Native *
Race: Asian *
Race: Black or African American *
Race: Hawaiian or other Native to Pacific Island *
Race: White/Caucasian *
Academic Information
Intended Graduation Term *
Degree *
In which of the following programs are you enrolled (or planning to enroll)? If your program is not listed you would be served by our SSS Classic program. Go here to learn more: https://bit.ly/3xRUMMh *
I am seeking a Degree at Santa Fe College with the intent to transfer to a four-year school. *
Which 4-year institution are you interested in transferring to when you complete your degree at SF? *
Are you now or have you ever been part of any of the following programs? *
Please select any of the following items that apply to you:
Are you a veteran? *
Homeless *
Foster Care *
How did you hear about STEM3S *

Section Two: Eligibility Information

As a federally funded TRiO program, Student Support Services at Santa Fe College is required to provide student eligibility documentation to the U.S. Department of Education. As stated in the Higher Education Act of 1965, at least two thirds of the students served must meet federal low-income guidelines and be the first in their family to attend college. The program's services are also designed to support students with a disability. 

The information requested ahead is used to determine your eligibility to participate in the program. Failure to accurately answer a question(s) or submit required documentation may result in denial of your application.

Your responses are protected by the Family Rights and Privacy Act and will be held in strict confidence.
Are you a U.S. citizen? *
If you are not a U.S. citizen, are you a U.S. Permanent Resident? *
If so, please provide your A# or USCIS#. If you are a US citizen, please enter NA.
Do you have a documented physical or learning disability? *
Are you, or do you intend to register with SF’s Disability Resource Center? *
What is the highest level of education completed by your biological/adoptive parent 1? *
What is the highest level of education completed by your biological/adoptive parent 2? *

Income Verification

STEM3S staff will first check your college FAFSA for income verification. If this is inconclusive for eligibility we will contact you to request a separate Income Verification Form. For dependent students this form must be signed by your parent or legal guardian. Please check your Santa Fe student email account to receive any updates or requests for more information.
 

Dependency Status

The income verification process varies depending on whether you are considered an independent student or a dependent student for federal financial aid purposes. Please review the guidelines carefully and select the option that most accurately describes you, or as you would select on your FAFSA.

Resources:
After reviewing the criteria, I am considered a(n): *

Section Three: Student Support

In which of the following areas would you like to receive services to support you academically? Please select all that apply.
Academic Support/Tutoring: *
I am undecided about my STEM career track. *
I have significant responsibilities (children, siblings, spouse, etc.) *
I have significant financial responsibilities beyond the cost of college. *
I plan to work 20+ hours per week while attending school. *
English is not my first language. *
Sometimes I feel like I do not belong. *
I lack a support structure at home. *
I have been out of school for over five years. *
I would like help creating study habits. *
I am afraid of failing a college course. *
I would like to find an internship. *
Statement of Interest
Why are you interested in becoming a STEM3S participant and how can we help you reach your goals? *

Section Four: Student Agreement

If I am accepted into STEM3S, I agree to the following:

  • I will meet with my STEM3S Academic Coach at least THREE times per semester.
  • I will develop an Individual Student Success Plan with my STEM3S Academic Coach each semester.
  • I will take ownership of academic success and personal growth.
  • I will be proactive in seeking help.
  • I will attend at least one STEM3S workshop or academic-enhancement event each semester.
  • I will make progress toward earning my degree by:
    • attending required class sessions and 
    • completing class assignments.
  • I understand that to be considered a STEM3S participant and to be considered for grant aid, I must participate in the program as outlined above.
Do you agree to the terms listed above? *
I give consent for the SF STEM3S program to use my photo and provide information on my participation in the STEM3S program in the STEM3S web page, brochures, newsletter, posters, and on social media. *
I understand that to be eligible for Student Aid I must abide by the Student Agreement, and that students in their first or second year of college will receive priority. *

Sign and Submit

I certify that the information I have provided on this application is, to the best of my knowledge, complete and correct.  Furthermore, I understand that by applying for the STEM3S Program, I authorize program staff to obtain records or data pertinent to my participation from other sources, and to release information, as required by law or the terms of the STEM3S grant, to the grant funding agency of the U.S. government. 

The STEM3S program staff has my permission to communicate verbally and otherwise with staff, faculty, and/or off campus professionals on my behalf. 

By signing below, I agree that this signature will be the electronic representation of my signature for all purposes when I use them on documents, including legally binding contracts; the same as a handwritten signature. 

**NOTE** If you prefer to not sign this document electronically, you may contact Melody Graveen, melody.graveen@sfcollege.edu, to receive it in paper form. 

Be sure to click "Sign and Submit Signature" and click the "I agree to the terms included" check box before submitting the application. 
Applicant Signature *
Please select a signature verification type.

Commitment to Equal Access and Equal Opportunity

Santa Fe College is committed to an environment that embraces diversity, respects the rights of all individuals, is open and accessible, and is free of harassment and discrimination. For more information, visit sfcollege.edu/eaeo.

Updated for the 2022-2023 school year. Access to this document was made possible by a federally funded Student Support Services STEM Grant for $261,888 from the U.S. Department of Education. These services are provided at no cost to students in an effort to ensure a successful post-secondary experience.