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Instructions: Please fill out this application as completely as possible. Review of applications will begin on June 15, and will continue as long as spots remain in the Summer Bridge program. Summer Bridge 2009 runs August 3 through August 14, Monday through Friday from 9:00 AM to 1:00 PM at Community College of Denver.

Today's Date:
Name (First, MI, Last):
S Number:
Birth Date:
Address:
City:
State:
Zip:
E-mail:
Cell or Home Phone:
Work Phone:
Gender:
Citizenship:
If Permanent Resident, Resident Alien #:

Check the box of other college support programs you are participating in or have in the past:
Ethnic Orgin:



English is my first language:
College Goal:

I have applied to CCD:
I plan to start taking courses at CCD:
High School GPA:
Date Graduated from High School:
Received GED:
Name of previous colleges attended:
Have you applied for financial aid at CCD?
If you are receiving financial aid, what types?
Have you applied for any scholarships?
If so, which ones?
Do either of your parent's have a Bachelor's degree (4 year)?
Do you have a physical or learning disability?
If so, please specify disability:
Do you have any dependents (children)?
Did you or your parents file income taxes for the preceding year?
Current size of household, including yourself:

Please select the amount which matches your parent’s taxable income for 2008. If you are married, or have a child, or are at least 24 years of age, then use your own taxable income. You will find taxable income on 1040 Line 43, or 1040A Line 27, or 1040EZ Line 6.

TRIO Scholars is a student support program that offers services such as academic advising, educational case management, career exploration, tutoring, textbook lending, financial aid application assistance, and much more to students pursuing Associate’s and Bachelor’s degrees. In one to three paragraphs, explain what challenges you face and how you would benefit from being in the TRIO Scholars program.