Triumph and Surge Application

* = required fields

Student Contact Information

Student Demographic Information

Self-identification is important, and we understand that we each have our own understanding of the words used to describe our own experiences. So that we can best honor your identity and experiences, please describe how you identify in the response box below AND select (as many as you want) from the list below.

Student Education Information

First Generation Status Information

Student Military Information

Additional 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 TRIUMPH and 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 TRIUMPH and SURGE and Triton College to use my image for program promotional purposes.

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