Thank you for your interest in our Talent Search program! Please complete this application as thoroughly as possible. You cannot save and restart this application. If you have any questions, please call our office at (719)549-2538.

General Information:

First Name: *

Middle Name:

Last Name: *

Date of Birth: *

Current Age: *

Student SSN:

Are you of Hispanic or Latino Origin?

Race:

Citizenship: *

Limited English Proficiency

Gender: *

Address: *

Address 2:

City: *

State: *

Zip: *

Student Cell Phone: *

Home Phone:

Email:

Adult T-shirt Size?

Academic Information:

Describe your primary reason for applying. *

Current Grade Level: *

Current School: *

Are you currently participating in any of the following programs? *

If In Middle School what High School do you Plan to attend?

Family Information:

With whom does student primarily live? *

Parent/Legal Guardian #1

Name: *

Relationship to Child: *

Phone: *

Email:

Parent/Guardian #1 Education Level: *

Parent/Legal Guardian #2

Name:

Relationship to child:

Phone:

Email:

Parent/Guardian #2 Education Level:

Income Information

How many people in your household? *

Taxable Income Range *

Federal TRIO Programs Current - Year Low-Income Levels

Effective January 19, 2023 until further notice

Sign and Submit:

Our signatures below indicate that to the best of our knowledge, the information given on this application is true, complete, and accurate. We authorize any public school, educational program, and/or postsecondary institution to release to the Colorado State University Pueblo TRIO Talent Search, upon their request, information pertaining to my academic, enrollment and financial assistance records.

With my signature below (parent, or student if 18 or over), I hereby grant permission to the staff of the Talent Search Program at Colorado State University Pueblo to access my (my child's) school records, including grades, test scores, and free or reduced lunch eligibility. These records will be used to assess student needs, monitor student progress, document eligibility for the program, and for reporting purposes.

I, (parent, or student if 18 years or older) hereby authorize post-secondary institutions to release to Talent Search copies of college academic, enrollment, and student aid award at the college/university I (my child) will be attending after high school graduation.

As a parent or legal guardian signing this form, I give permission for my child to participate in all program-sponsored activities and for any Talent Search staff member to transport my child to and from program-sponsored events. I waive liability, release, and forever discharge Colorado State University Pueblo and the State Board of Governors of the Colorado State University System, all of its members, and anyone employed with community or educational organizations in partnership with Talent Search from any and all demands, rights, and causes of action of whatever kind of nature arising out of all known and unknown, foreseen and unforeseen bodily and personal injuries, damage to property, and the consequences thereof, including death, resulting from my child’s voluntary participation in Talent Search. I authorize my child to be treated by qualified medical personnel if the need arises while engaged in official Talent Search activities.

I give permission for the use of my (my child's) name and/or photograph for editorial, promotional, recruitment, or educational purposes.

If accepted into the program, I agree:

-To participate in Educational Talent Search programming at least once a semester.

-To stay updated about Educational Talent Search programming by following the progam's social media, reading text messages/emails/snail mail, etc.

-To update Educational Talent Seach staff if my contact information or address changes.

-To attain personal, academic, and career goals that I and Educational Talent Search set for myself.

-To treat myself, other Educational Talent Search students, and staff with respect, and be a positive representative of the program.

I also understand that if I (my child) do not follow Educational Talent Search expectations, or if I (my child) do not participate in the program for a full year, I (my child) will be dismissed from the program.

Student Signature *

Please select a signature verification type.

Parent/Guardian Signature *

Please select a signature verification type.