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.  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 (580) 477-7857 OR (580) 477-7916.
General Information:
Last Name: *
First Name: *
Middle Name:
Date of Birth: *
Describe your primary reason for applying: *
Address: *
Address 2:
City: *
State: *
Zip Code: *
Home Phone
Cell Phone Number:
Email Address:
Are you a U.S. Citizen *
Are you in the U.S. Military or a Veteran?
Disclaimer: The following information is collected for reporting purposes only and will NOT impact admission to the program or services provided. 
Hispanic *

Race

Please Select All that Apply

(You must Select (Yes or No) for each option
American Indian or Alaskan Native
Asian
Hawaiian or other Native to Pacific Island
White *
Black or African American *
Gender *
Have you applied for financial aid (sumbitted this year's FAFSA)? *
Program Eligibility
Do either of your parents have a bachelor's degree?
Do you have a disability, either physical or learning, that is documented through WOSC Student Affairs?
Did you live in foster care or DHS custody at any time after the age of 13?
Have you previously participated in a TRIO program (Talent Search, Upward Bound, EOC, SSS, or Gear UP?
Academic Info:
Current Grade Level: *
How many classes are you taking?
Current GPA:
How's your academic standing?
Do you plan to seek a bachelor's degree?
Family Information:
Parents Educational Level:
How many people in your household at home?
Family Income Range:
Most Recent IRS 1040
Sign and Submit:
Applicant Signature *
Signature Type: SMS    Start Over
After validation, the cell phone number will become part of the electronic signature.
Cell Phone Number:

Terms of Submission:
By submitting this application, you acknowledge that all of the above information is correct and accurate to the best of your understanding.