Thank you for your interest in our TRIO Student Support Services program at Heritage University!  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. 

Fields with an asterisk * are required.  

Once your application is submitted, the TRIO SSS staff will review your application for eligibility and contact you with next steps.  

If you have any questions, please call our office at (509) 865-8550 ext. 1725

Personal Information:
Cell/Home Phone *
Heritage University Student ID Number *
Heritage University Student Email Address: *
Last Name: *
First Name: *
Middle Name:
Date of Birth: *
Of the following five races, please select at least one that you most identify with: *
Describe your primary reason for applying:
Address: *
Address 2:
City: *
State: *
Zip Code: *
Can we text you? *

Current Grade Level: *
What Heritage University Campus will/are you studying at?
Are you a current CAMP student?
Current Enrollment Status: *
Current GPA: *
How's your academic standing?

Program Eligibility:
Are you a United States Citizen? *
If you are a Permanent Resident, please upload a copy of your Permanent Resident Card.
Parents/Guardians Educational Level: *
How many people in your household at home?
Family Income Range (estimate):
If yes, have you documented it with the Accommodation Specialist at Heritage University?
Do you have a Documented Disability (shared with HU Office of Ability Services)? *

For additional information regarding the Office of Ability Services please email Bianca Chavez, Counselor & Accommodation Specialist at or call (509) 865-8544 (Ext. 1742).

Sign and Submit:
Applicant Signature *
Please select a signature verification type.

Terms of Submission:
By submitting this application, I acknowledge that all of the above information is correct and accurate to the best of my knowledge. 
I give TRIO SSS permission to request records to verify my eligibility to the program; such as accommodation forms from the Accommodation Specialist and Family Income information from the Office of Financial Aid.