Thank you for your interest in our TRIO Student Support Services program at Pacific! 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 information, and then return to submit your application. 

If you have any questions, please feel free to drop by Clark 327, email TRIO@pacificu.edu or call us at (503) 352-2746.

PLEASE NOTE: This form asks for sensitive information that will be stored with a third party service provider and will be reported to the federal Department of Education. Please contact us if you have any questions or concerns about data security.

------------------------------------------------------------------------------------------------------------------------------------------------------------------------

¡Gracias por su interés en el Programa de Servicios de Apoyo al Estudiante TRIO de Pacific University! Por favor complete esta postulación de manera exhaustiva.

No es posible guardar o reiniciar esta postulación. Recomendamos que revise las preguntas e ítems, tome nota, recoja la información requerida y luego envíe su postulación.

Si tiene alguna pregunta, no dude en acercarse a Clark 327, enviar un correo electrónico a TRIO@pacific.edu o llamarnos a (503) 352-2746.

TENGA EN CUENTA: Este formulario requiere que responda sobre información sensible que será almacenada por un proveedor de servicios contratado. Esta información será reportada el Departamento Federal de Educación. Por favor contáctenos si tiene preguntas o dudas acerca del manejo y la seguridad de los datos.
General Information:
Legal First Name: *
Preferred First Name: *
Middle Name:
Last Name: *
Pronouns:
Pacific ID Number: *
Are you a current student or incoming student? *
If you are an incoming freshman or transfer, some questions might not apply to you exactly. Just answer the best you can.
Date of Birth: *
Street Address: *
City: *
State: *
Zip Code: *
Pacific Email Address: *
Cell Phone Number:
If you give us your phone number, we will send you an opt in text message to make sure it is okay to text you.
Demographic Information:
Are you Hispanic or Latino? *
Per federal regulations: Hispanic/Latino/a/e/x refers to a person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race.
What is your race? (Select all that apply)
American Indian or Alaskan Native *
Asian *
Black or African American *
Hawaiian or other Native to Pacific Island *
White *
What is your US Citizenship Status? *
What is your gender identity?
What is your legal sex? *
While we respect the gender identity of all students, we are required to report "Legal Sex" as part of federal requirements.
Eligibility Information:
Are you currently working towards your first Bachelor's degree? *
Do either of your parents or guardians have a 4-year Bachelor's degree? *
Please select your eligibility criteria⁺ *
Do you have a documented disability as verified by OAA or another health professional? *

If you qualify based on all three categories, please select "Low-Income and First-Generation" from the drop down list, and select "Yes" to the question above.
Do you utilize services from the Office of Accessibility & Accommodations?
Tell us about your interest in the TRIO program. What support are you hoping to receive? *
Education Information:
Current Grade Level: *
Are you a transfer student, if so, where did you transfer from? *
Enrollment Status *
For full-time please select "Full-time (at least 24 credit hours or 36 clock hours in an academic year)"
What is your major(s) and/or minor(s)? *
Current Cumulative GPA: *
What is your current academic standing?
How many classes are you taking?
Family Information:
Parents highest level of education:
How many people are in your household at home? *
Family Income Range: *

This would be your family's taxable income. This can be found on US Individual Income Tax Return - IRS Form 1040, see Line 15. You may need to ask a family member for this number -- please try to provide the most accurate selection.

NOTE: family is defined as anyone who claims you as a dependent on their taxes regardless of your age. If you are an independent student, you must enter your taxable income information just for yourself. 

 
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.