This application gives us permission to serve you. You cannot save and restart this application.

Questions? Please call (352) 381-7228 


General Information:
Last Name *
First Name *
Date of Birth *
Ethnicity *
Gender *
Address *
City *
State *
ZIP Code *
Cell Phone *
May we send occasional text messages about program information to your cell phone? *
Current Age
Email

Additional Info:
What services are you interested in learning more about (financial aid, GED, college enrollment, etc.)?
Highest level of education completed *
Are you connected to the military? *

Family Information:
Parent 1 Educational Level *
Parent 2 Educational Level *
How many people in your family including self? *
Family Income Range *
What was your taxable income last year, as shown on tax form 1040, line 15?
Citizenship *

Sign and Submit:

My signature below certifies that the information provided in this application is correct to the best of my knowledge. I grant the Educational Opportunity Center permission to send for/receive copies of transcripts, financial aid information/awards, student aid reports, test scores, and other relevant information necessary for permission in the program and allow state/federal agencies permission to release any/all income information.

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Signature: (Type in your full name)
I agree to the terms included.

Applicants under the age of 24 require a parental signature

Exceptions to this rule include:

  • veterans
  • married individuals
  • individuals who have been legally declared independent

 

Parental Signature if Applicable
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