Submit Your Application

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 (405) 682-7865.

General Information:

Last Name: *

First Name: *

Middle Name: *

Date of Birth: *

Address: *

Address 2: *

City: *

State: *

Zip Code: *

Home Phone *

Cell Phone Number: *

OCCC Email Address: *

OCCC Student ID Number *

SA Ethnicity *

Gender *

What is your citizenship status? *

Have you applied for financial aid (submitted the current FAFSA)? *

Did you live in foster care or DHS custody at any time after the age of 13? *

Do you have a disability, either physical or learning, that is documented through OCCC Student Support Services? *

Have you previously participated in a TRIO program (Talent Search, Upward Bound, Student Support Services, Educational Opportunity Center. etc...)? *

Academic Info:

Current Grade Level: *

How many classes are you taking? *

Current GPA: *

How's your academic standing? *

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 *

Please select a signature verification type.

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. I give my permission for the OCCC offices of Admissions, Records and Financial Aid to release relevant financial and academic information about me to TRIO Student Support Services. I give my permission for TRIO Student Support Services to access my educational history and previous TRIO Program participation, including dates enrolled at any institutions of higher education. I understand that, if I am selected as a participant, my name will be displayed inside the TRIO office on sign-up sheets and visible to other TRIO participants. I give TRIO SSS permission to use my image and name in promotional items (i.e., brochures, web pages, Facebook).*