Thank you for your interest in our Talent Search 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 Lisa. Her cell phone is (612) 801-5589.

The Educational Talent Search program is funded to serve students who meet the eligibility criteria of low-income and/or first generation potential college student status. In meeting this federal regulation we ask that you provide the following information used to determine eligibility. You are not legally required to provide the information ETS is requesting; however ETS will not be able to consider your application if you do not provide sufficient information. The information you provide is private information and used solely to determine eligibility, report aggregate data and to track student success.


General Information:
Last Name *
First Name *
Middle Name
Date of Birth *
Gender
Decline to Answer
Race/Ethnicity *
Address *
Address 2
City *
State *
Zip *
Phone
Cell Phone *
Email *
Services you may be interested in - check all that apply:
Tutoring
Mentoring
Summer Program for grades 9-11
Career Exploration & Planning
College Visits
Financial Aid Information
Post Secondary Planning
Are you a U.S. Citizen or U.S. Permanent Resident? *
Social Security Number/Permanent Resident Number
Are you part of any other college readiness programs? Check all that apply
College Possible
Upward Bound
GEAR UP/Get Ready

Academic Information:
Current Grade Level *
Current School *
Current Age *

Family Information:
Parents/Legal Guardians Highest Education Level *
Parent/Legal Guardian Name *
Parent/Legal Guardian cell phone *
Parent/Legal Guardian email *
Parent/Legal Guardian #2 Name
Parent/Legal Guardian #2 cell phone
Parent/Legal Guardian #2 email
List siblings in grades 6-12 with NAME, GRADE, SCHOOL
Household Income Range *
How many people in your household including yourself? *
Do you or your family qualify for free or reduced lunch *
Emergency Contact Name *
Emergency contact cell phone *
I give permission for the use of my child’s name and/or photograph for editorial, promotional, recruitment or educational purposes:
*

The personal information that you give to the Educational Talent Search Program is for the U.S. Dept. of Education. This information is protected by the Privacy Act. No one may see the information unless they work with or for the Educational Talent Search Program or are specifically authorized to see it. The information is necessary to determine if your child is eligible to participate in the Educational Talent Search Program and helps the U.S. Dept. of Education to measure his/her success. The U.S. Dept. of Education has the authority to gather such information. Your child is not eligible for any services from the Educational Talent Search unless the information is given.

Further, I/we authorize ETS representatives to communicate with representatives from postsecondary institutions and access enrollment records from the National Student Clearinghouse on my (my child’s) behalf for up to six years post high school graduation. This also authorizes the postsecondary institution in which said student is enrolled to release information about admissions, college academic enrollment and financial aid information including award letters

By signing below, I/we:

•Certify that all the information provided on this application is true and correct

•Authorize my child’s school to release records (grades, attendance, transcripts, standardized test scores, ACT/SAT scores) to the Hennepin Technical College ETS Program

•Authorize the release and exchange of my child’s financial aid information from colleges and federal government to ETS

•Understand that the completion of this application does not guarantee acceptance in the ETS program


Sign and Submit:
Applicant Signature *
Signature Type: Simple    Start Over
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Signature: (Type in your full name)
I agree to the terms included.

Parent/Guardian Signature *
Signature Type: Simple    Start Over
Click here to start signing.
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Signature: (Type in your full name)
I agree to the terms included.