Thank you for your interest in our TRIO Student Support Services program at Randolph and Williston!  Please complete this application as thoroughly as possible.  You cannot save and restart this application.  If you have any questions, please call us at: 802-728-1396 (Randolph) / 802-879-2329 (Williston).

Please note: You are not eligible to apply if you (a) already have a 2 or 4 year degree, and/or (b) you are in a degree program without an Associate option (Pilot Technology, Manufacturing Engineering, Renewable Energy).
Student Information
Last Name: *
First Name: *
Middle Initial:
Preferred Name:
Date of Birth (xx/xx/xxxx): *
School Email Address: *
Student ID: *
Cell Phone Number:
May we text you periodically with reminders and timely information to support your success?
Campus Location *
Do you already have a 2 or 4 year college degree? *
VTSU Academic Support is funded in part by a TRIO grant from the U.S. Department of Education. This grant enables us to provide additional academic support services to students who are first generation college students, low-income students, or students with documented disabilities. Your answers to the questions below will assist us in determining your eligibility.
Family and Financial Information
With whom do you live (or, if independent, whom did you live with at age18)? *
What is the highest level of education completed by either parent (biological or adoptive)? *
Ethnicity:
Are you a U.S. citizen?
Have you applied for Financial Aid? *
Did you receive a Pell Grant? *
Academic Information
Do you have a documented disability? *
Program of Study:
Institution Start Date: *
Anticipated Graduation Date:
Please describe at least two areas where you are strong academically:
What specific academic needs do you have that you believe could potentially impact your success at VTSU? Please select from the below drop-down menu options.
Primary Academic Need *
Secondary Academic Need
Other Academic Needs
Did you participate in any of these programs?

Federal Tax Information & Financial Aid Authorization for TRIO SSS

To determine your eligibility for the TRIO Student Support Services (SSS) program and related TRIO grant aid at Vermont State University (VTSU), we request your authorization to use Federal Tax Information (FTI) from your Free Application for Federal Student Aid (FAFSA).

By signing below, you allow the VTSU Financial Aid Office to:

  • Use your FAFSA data, including Adjusted Gross Income (AGI) and family size, to evaluate your financial eligibility for TRIO SSS.
  • Share your eligibility status (i.e., whether you meet financial criteria) with TRIO SSS staff.

TRIO SSS staff will not have access to your AGI or any specific financial data—only whether or not you meet the federal income guidelines to participate in the program.
Authorization: *

*You may revoke this authorization at any time by submitting a written request to the VTSU Financial Aid Office. Revocation will only apply to future use of your information and will not affect any information already shared.

This authorization applies only to the current financial aid year. You will need to complete a new authorization for any future year you wish to be considered for TRIO SSS services or grant aid.

Important: If you do not authorize the use and limited sharing of your FAFSA data as described above, the Financial Aid Office will not be able to verify your financial eligibility for TRIO SSS, which may impact your ability to participate in the program or receive TRIO grant aid.

 
Sign and Submit: 
Applicant Signature *
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Signature: (Type in your full name)
I agree to the terms included.

Confidentiality and Student Signature:

Important! Randolph Academic Support staff handle student information confidentially to assist in verifying your TRIO eligibility to the Federal Government and/or providing you with academic/personal services. Your signature below verifies your agreement with the three statements below.

1. I authorize Randolph Academic Support to obtain disability data, verify citizenship and verify my academic standing (when necessary) to either provide or initiate Student Support Services for me, and to share this application with other TRIO Student Support Services staff within Vermont State University for the purpose of providing me with the appropriate services at my location.

2. I give Academic Support permission to request feedback from my professors and I agree to meet with Academic Support staff if my professor(s) indicate that my performance is unsatisfactory.

3. I certify that the information I have provided on this application is correct to the best of my knowledge. I understand that if any of this information is found to be false, my eligibility for TRIO Student Support Services will be jeopardized.