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Brown Hall Suite 345, 105 West O Street, Russellville, AR 72801
trio.sss@atu.edu  479-880-4172
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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.Â
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RACE & ETHNICITY: Please choose ALL that apply
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American Indian or Alaskan Native
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Black or African American
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Hawaiian or other Native to Pacific Island
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Did your Mother graduate with a 4 year bachelor's degree?
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Did your Father graduate with a 4 year bachelor's degree?
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What is your Major? (If you're not an education major, please fill out the Student Support Services Application at www.atu.edu/sss)
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Do you have a documented physical or learning disability?
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If Yes, have you registered with Tech's Disability Services?
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Upload a copy of your disability accommodations letter from your online portal
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Have you completed the FAFSA?
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Check box if you are receiving Pell Grant
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Check box if you are receiving Student Loans
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Check box if you are receiving Scholarships
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Check box if you are receiving work-study
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When you are not in school, who do you reside with?
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How many people are in your family/ live in your household? (Include those away in school and yourself)
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Do you have any children?
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ACADEMIC NEED: Check ALL That Apply (Must Check at least One):
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Low Admission Test Scores (ACT, SAT, ACCUPLACER
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Out of school for more than 5 years
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Limited English Proficiency
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Lack of educational/career goals
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Lack of Academic Preparedness
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Need for academic support to raise grades in required courses/major
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Check the services which are of greatest need: (Must check at least One)
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Financial Aid Information
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How did you learn about Student Support Services?
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SIGN AND SUBMIT:
Student Informed Consent Agreement
I certify that
the information I have provided is true and correct to the best of my
knowledge. I give my consent for Arkansas Tech University Student
Support Services Program to release and receive academic and/or
financial aid information in order to provide appropriate services.
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Click here to start signing.
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Click here to start signing.
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