GENIUS Program Scholarship: Request for Information/Pre-Application

First Name *

Middle Initial

Last Name *

Maiden Name

Address *

Apartment/Unit

City *

State *

Zip Code *

Personal Email *

Phone

Triton Email (if applicable)

Birthdate *

High School Attended or Currently Attending *

College Attended or Currently Attending (if Applicable)

Cumulative GPA *

Are you Currently Enrolled at Triton College? * Yes No

Current Program at Triton College * (if Currently Enrolled) Not Applicable/Not Currently Enrolled at Triton AAS Certificate College Transfer Other

Current College Major or Intended College Program Study/Major *

PDFs Only
Each attachment should be no larger than 300KG in size.
Confirmation of successful file uploads will display on the summary message following submission.

File 1: Most Current & Latest Unofficial Transcripts * (High School or College)

File 2: Essay - How do you see the GENIUS program enhancing your future education and career to improve the lives of people and/or the environment? * (In 500 words or less)

Please note: Captcha is case-sensitive

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