Project Stay Application

Welcome to the Project Stay application page! To complete this application, you will need to reference your 2009 federal tax forms. If you are a dependent student by financial aid standards, you will also need to reference your parents' 2009 federal tax forms. Information from the federal tax forms is used to screen for financial eligibility.

Please bring copies of the pages on yours and your parents' tax forms that shows taxable income as soon as possible after submitting your application. If you are not sure what pages to copy, bring in the forms and we'll make copies of the pages we need.

A Project Stay staff member will call you for an interview once your application has been processed. NOTE: Your application cannot be processed without 2009 tax forms.

	*Student Name (First, M.I., Last)
	*S#
	*Home Address
	*City, State, Zip
	*Home Phone (include area code)
	*Cell Phone (include area code)
	*Date of Birth (mm/dd/yyyy)
	High School
	*Gender
	*Campus Email Address
	*Marital Status (Select One)
	Ethnic Background (Select One) Note: This information will be used for federal reporting only. Providing this information is optional.
	*Are you a United States Citizen or Permanent Resident?
	Do you receive accommodations on campus* for a disability?
	*Are you employed?
	Employer
	How many hours per week do you work?
	Have you been a participant in a TRIO Program before? (Upward Bound, Talent Search, Upward Bound Math/Science, Student Support Services, EOC)
	How did you hear about Project Stay?
	*How many members are in your household?
	*Are you a single parent?
	What is the highest level of education your natural, adoptive, or step father completed*?
	What is the highest level of education your natural, adoptive, or step mother completed*?
	*Are you recognized as an independent student by the financial aid office? (Note: Independent students are generally students who are 24 years of age or older, are married, have children, are orphans or wards of the court, are veterans, or have successully filed a petition for independent status with the financial aid office. Independent students do not have to complete the parent tax information.
	*What federal tax form did you file in 2009?
	What federal tax form did your parents' file in 2009? Note: if you are an independent student by financial aid standards, choose 'Not Applicable'.
	*What was your taxable income on your 2009 federal tax forms? (form 1040 line 43, form 1040A line 27, form 1040EZ line 6)
	What was your parents' taxable income on their 2009 federal tax forms? (form 1040 line 43, form 1040A line 27, form 1040EZ line 6) Note: if you are an independent student by financial aid standards, you may skip this question.
	What is your major/minor?
	How many college hours have you completed?
	Who is your academic advisor?
	What are your plans after graduating from college? Include information on graduate school plans and employment. Please be as specific as possible.

* Required Information

The information I have submitted on this application is true to the best of my knowledge. If selected for Project Stay, I understand that I am expected to satisfactorily maintain my grade point average, participate in Project events, and work closely with my Project Stay advisor to accomplish my educational goals. I understand that Project Stay staff may consult my current instructors to collect information about my class attendance and class work completion. I agree to permit Project Stay staff access to my grade reports, financial aid documentation, and other confidential records necessary for program documentation and evaluation.

IMPORTANT: Project Stay cannot process your application without copies of the appropriate tax documents, your social security number, and your signature.
Please bring these by the Project Stay office as soon as possible after submitting your application.

I understand and agree to the above statement.

For additonal information, contact the Project Stay office 625-9830.

Thank you for your application!