TRiO
Student Support Services
3302.3 C.B. Hedgcock
Marquette, MI 49855
E-mail: sss@nmu.edu
(906)227-1550
Fax: (906)227-1510
Application for NMU’S
Student Support Services Program
Student Support Services is a federally sponsored TRIO program. All participants must meet
specific eligibility criteria to be considered for participation in the program. By completing this
application and responding to all questions to the best of your ability, we will be able to promptly
process your application and determine you eligibility for your participation.
Name:_ ________________________________________ NMU IN: ______________
(First)
(M.I.)
(Last)
Local Address: ___________________/_________________/_________/___________
(Street)
(City)
(State)
(Zip Code)
Permanent Address: _______________/_________________/_________/___________
(Street)
(City)
(State)
(Zip Code)
Local Phone: ______________Cell Phone: _________________e-mail: ____________
How did you hear about the Student Support Services Program?
______________________________________________________________________________
______________________________________________________________________________
Are you a United States Citizen?
□ Yes □ No
Are you currently enrolled at Northern Michigan University?
□ Yes □ No
If you are not currently enrolled, when to you anticipate enrolling ______________
What is the highest level of education reached by your natural or adoptive mother?
□ None
□ Elementary
□ Middle School
□ Some College □ Associates Degree
□ High School
□ Bachelor’s Degree
□ GED
□ Graduate Degree
What is the highest level of education reached by your natural or adoptive father?
□ None
□ Some College
□ Elementary
□ Middle School
□ High School
□ GED
□ Associates Degree □ Bachelor’s Degree □ Graduate Degree
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Do you have a documented learning or physical disability?
□ Yes □ No
If yes, what is your disability? __________________________________________
As part of the qualification process for Student Support Services, we are required to have
verification of your household income. Please attach a copy of a current federal tax
transcript for:
o
o
Parents federal tax transcript if you were claimed as a dependent student
Your own federal tax transcript if you filed as an independent
A federal tax transcript may be ordered from: http://www.irs.gov/Individuals/Get-Transcript
OR: In many instances, the necessary financial information needed to complete your
Student Support Services application may be obtained through NMU’s Financial Aid
Office. Your signature below indicates that the Student Support Services program has
permission to verify your financial information through Northern Michigan University’s
Financial Aid Office.
______________________________________________
(Signature)
______________________
(Date)
We’re pleased that you have chosen to enroll at Northern Michigan University. Please
share your reasons for pursuing a university education.
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Tell us about your academic strengths and areas you feel need improvement.
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
What are your special interests and previous involvement in school and community
activities?
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
What are your concerns regarding being successful at Northern Michigan University?
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
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TRIO/ Student Support Services
Student Needs Assessment
This inventory will help in assessing your needs for services which are offered by the TRIO/Student
Support Services Program. Please check YES or NO in response to each of the following questions.
Yes
No
1.
I would like to learn more about my individual learning style .
____ ____
2.
I would like to manage my time more efficiently
____
____
3.
I would like to become a better test taker.
____
____
4.
I am interested in academic support such as tutoring.
____
____
5.
I need to improve my study habits and skills.
_____
_____
6.
I need to improve my writing skills.
_____
_____
7.
I need to improve my math skills.
_____
_____
8.
I need to improve my reading skills.
_____
_____
9.
I am confused about where to start in choosing a career path.
_____
_____
10.
I want to learn which careers typically match my skills, interests
and personality traits.
_____
_____
I am distracted by personal matters to the point that I am having
trouble studying.
_____
_____
I feel uncomfortable communicating with professors, residential life
staff, my roommate, or other students.
_____
_____
I would like to know more about assistance that is available for
commuter students.
_____
_____
14.
I need help with the financial aid process.
_____
_____
15.
I would like to learn about disability services on campus.
_____
_____
16.
I would like to take advantage of disability services (e.g. information/
questions about disabilities, classroom accommodations, etc.).
_____
_____
I would like to receive academic advising to prepare me for entry into
my major.
_____
_____
18.
I need personal support and encouragement.
_____
_____
19.
I would like to learn more about financial & budgeting concerns
many students encounter.
_____
_____
11.
12.
13.
17.
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If you are accepted into the Student Support Services program, which of the services
listed below do you feel would help support your goals of academic success?
□ Core Tutoring: Core tutors assist students on a regularly scheduled basis. They may
assist you with the development of effective study habits, time management skills,
academic tutoring, as well as assisting students new successfully ‘navigate’ through the
university
□ Specialized Tutoring: Specialized tutors focus upon assisting students with specific
course content and related study techniques for that course.
□ Study Groups: Study groups are led by a tutor and are often conducted to support
classes which are challenging for all students.
□ Academic Skill Building: These sessions led by the learning skills specialist assist
students in identifying specific academic needs and the development of strategies to
improve academic performance.
□ Supplemental Instruction: There are instances where students’ do not have the
necessary prerequisite academic skills to be successful in a university course.
Supplemental instruction leaders provide this ‘missing information through small group
and individual instruction sessions.
□ Access to Social and Cultural Activities: The Student Support Services program
strongly encourages participants to attend a variety of social and cultural events in both
the university and Marquette communities. We often provide tickets for university theatre
productions the Performing Arts series.
Please feel free to include any additional information you would like us to consider while
reviewing your application.
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
___________________________________________
(Signature)
________________________
(Date)
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