Student Support Services/ Project Success Application

Please note that this information will be submitted via non-secure e-mail. Please do not send your social security number or other information that you do not want someone else to know. Individuals under the age of 13 should not use this form.

Project Success is a federally funded Student Support Services TRIO program that is designed to improve the retention, transfer, and graduation rates of the 160 low income, first generation, or disabled college students whom we serve.

Project Success accepts all students who are seeking an associate's degree; however, preference will be given to students who intend to transfer to a 4 year college or university. 

The Tab key may be used to move from one field to the next.

Please Choose one*
Are you planning to transfer to a 4-year college or university*

Please provide your first and second choices.
Have you taken the IVCC Placement Tests?*

Hold down the CTRL key to select multiple options
Have you applied for financial aid*

If you do not apply for financial aid you can not participate in Project Success
Father highest level of education*

Indicate the highest level of education completed by your father or legal guardian before you reached the age of 18.
Mother's highest level of education*

Indicate the highest level of education completed by your mother or legal guardian before you reached the age of 18.
Will you participate in Project Success sponsored events and workshops
Do you anticipate a problem with any of your classes this semester?

Hold down the CTRL key to select multiple options

Hold down the CTRL key to select multiple options

Hold down the CTRL key to select multiple options
Gender
High School graduate:*
GED?
Are you a United States citizen
Are you disabled:
I release rights to photographs taken by any IVCC employee for use in possible promotions or other materials
 

By submitting this form I am  giving Project Success staff members access to the following information: standardized test scores, high school transcripts, mid semester and semeter grades, financiall aid office records, admission office records, counseling office records and records pertaining to a documented disability. I also give permission to my instructors to provide written or verbal evaluations of my academic progress to Project Success staff. I also give my permission for Project Success staff members to communicate, on my behalf, with IVCC professional staff/faculty who are not Project Success staff members. I certify that the information contained in the application is, to the best of my knowledge, true and accurate.