TRIO Running Start 26-27 | Northeastern Junior College

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First

Last

Phone or Cell number at which we can reach you at most

Can we text you at this number?

Yes

Confirm email

I want to apply for the TRIO Running Start Program, Aug. 9th-12th, 2026

Yes

I am going to live in the residence halls.

Yes

Have you already applied for the TRIO program?

Yes

You may have already done this when you signed up for registration day. If yes, you can scroll to the bottom and submit

No or I'm not sure

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Math question

8 + 4 =

Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.

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Part 1: Personal Data

The name I go by is:

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

NJC Student Number (S#)

Birthdate

Birthdate: Month

Birthdate: Day

Birthdate: Year

Age

Gender

Part 2: Race

Please select ALL that apply

American Indian/Alaskan Native

Asian

Black or African America

Native Hawaiian or Other Pacific Islander

White

Part 3: Citizenship

Your citizenship status is:

Part 4: Ethnic Origin

Hispanic/Latino (Select YES if you are a person of Cuban, Mexican, Puerto Rican, South or Central American or Spanish culture or origin)

Part 5: Educational Information

Please select what you graduated with

Graduation Year

Graduation Year: Year

NJC Major

What month/year was your first enrollment date at NJC? (Excluding classes taken while in high school)

What month/year was your first enrollment date at NJC? (Excluding classes taken while in high school): Month

What month/year was your first enrollment date at NJC? (Excluding classes taken while in high school): Year

Is your goal to transfer to a four-year college or university?

Do you have a documented disability that effects learning?

Part 6: First Generation Verification

Did your mother/legal guardian graduate with a 4-year Bachelor degree from a college or university?

Did your father/legal guardian graduate with a 4-year Bachelor degree from a college or university?

Who were you living with up to your 18th birthday?

Part 7: Need for Academic Services

Please check ALL the goals you may consider using for your educational support:

Academic Tutoring and/or Study Groups

Improve my study skills (note-taking, test-taking, textbook reading, writing, time management, etc.)

Assistance with Career or Personal Counseling

Assistance in transferring to a 4-year college

Assistance with Academic Advising

Assistance in obtaining and/or applying for financial aid

Part 8: Income Verification

Information message

All answers are confidential and reported as group data for program documentation purposes only. Please answer the following questions based on your 2025 Income Tax Information.

Status message

Below, please select whether you are a/an Dependent Student or Independent Student.

Description of student types:

Dependent Student: You are considered a Dependent Student if you were claimed on your parents' income tax return in 2025. All information below is to be completed based on your PARENTS'/Guardians' entire household and should be filled out by YOUR PARENTS.
Independent Student: You are considered to be an Independent Student if you meet any of the following criteria:
- I will be 24 or older by December 31 of this year.
- I have been an orphan, in foster care, or a ward of the court after age 13.
- I have children who receive more than half their support from me.
- I am married (or separated, but not divorced).

I am considered a/an:

Check ALL that apply to you being an Independent Student

I am age 24 or older by December 31 of this year.

I have been an orphan, in foster care, or a ward of the court after age 13.

I have children who receive more than half their support from me.

I am married (or seperated, but not divorced)

Information message

All information below is to be completed based on your entire household for 2025.

Size of family unit including Student in 2025 (Select one):

State of Residence in 2025 (Select one):

2025 Taxable Household Income (Taxable household income can be found on the federal income tax return, IRS Form 1040, line 15)

Part 9: Authorization Statement

If you are under 21, please answer the following statement:

I certify the information provided on this application is true and complete to the best of my knowledge. I understand this information is confidential and will be used for grant purposes. I hereby authorize MLC TRIO to secure information pertinent to my participation in MLC TRIO at NJC. This release covers, but is not limited to, access to financial aid information, standardized test scores, transcripts, grade reports, my instructors and any information concerning my academic progress and performance to generate necessary reports to insure continued operation of the facility. The MLC TRIO office will request and share this information as deemed necessary to further student success. Additionally, student images maybe used from time to time for publicity purposes.

All information provided on this form is true and correct, and all the fields are complete.

Signatures:

Student Signature (required)

Sign above

Today's Date

If student IS A DEPENDENT, a parent/legal guardian MUST SIGN to verify income.

Check if your parent is not present with you to sign this form. Please enter their email address in the spot provided so the income verification can be emailed to them for completion.

Parent/Guardian's Email Address:

Parent Signature (DEPENDENT students)

Sign above

Information message

This program was developed under a TRIO Student Support Services grant from the Department of Education (ED). However, activities do not necessarily represent the policies of ED, and you should not assume endorsement by the Federal Government.

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