CH Test Page

Student Contact Information


Student Demographic Information


Student Education Information


First Generation Status Information


Student Information


Student Response


Please provide short responses to the following questions:

Student Verification


By signing this application, I attest that all the information on this application is true and accurate. I authorize the release and disclosure of official school records to SURGE; understanding that the information in these records will be used only to assess need for program services, including referral for financial assistance, but not limited to scholarships, federal financial aid, work study, monitoring educational progress, evaluate the effectiveness of program activities, and fulfill program reporting requirements. I also allow SURGE and Triton College to used my image for program promotional purposes.