Thank you for your interest in our Talent Search program! 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.

*You will also need your Parent/Guardian present to complete the application.

If you have any questions, please call our office at (406)496-4694

Application for services with Talent Search

Student First Name *

Student Middle Name

Student Last Name *

Students current age *

Students Preferred Name

Students Date of Birth *

Student ID/ State ID if known

Gender *

Mailing Address *

Address 2

City *

State *

Zip *

Home Phone *

Student Cell Phone

Student Email Address

Parent/Guardian Email Address *

Emergency Contact *

Do you have any disabilities? (Check all that apply) *

Physical

Learning

Emotional

Other

Please explain *

Is the student Hispanic/Latino *

Ethnicity *

Citizenship Status

Are you a Citizen, National, or Permanent Resident of the United States? *

Education

Students Current Grade Level *

What School do you currently attend? *

Describe your primary reason for applying *

Where did you learn about Talent Search?

Educational & College Plans

What are your Educational Plans? *

List any colleges/universities that are of interest to you:.

What services are you interested in receiving? (Check all that apply)

Academic Advising (include Course Selection)

ACT & SAT Preparation

Career Planning & Exploration

College Planning & Exploration

College Visits & Cultural Field Experiences

Financial Aid Information ( Including Scholarships)

Financial and Economic Literacy

Mentoring and/or Tutoring Opportunities

Summer Activities

Family Information

Is the Student a Ward of the State? *

Parent or Guardian's Name *

Parent or Guardian Marital Status *

With whom does the student live? *

How many people live in your household including yourself? *

Did either parent/legal guardian that you live with earn a bachelors degree (four year degree) *

If yes, which parent earned his/her bachelors degree?

Montana Tech Talent Search is federally funded and requires verification of every participant’s income. Please check your TAXABLE income for the previous year (line 15 on 1040 form).

*** Taxable income is your adjusted gross income minus your deductions.

Does the student qualify free or reduced lunch? *

Do you receive public assistance such as SNAP, TANF, etc? *

Family Taxable income: *

Refer a friend

Do you know any other students who may be interested in free educational and career services offered by Montana Tech Talent Search?

Name:

Address:

Phone Number:

School Attending:

Name:

Address:

Phone Number:

School Attending:

Sign and Submit

Parent/Guardian: Please review this application to be sure that everything is filled in and correct. By signing this form you are certifying the income information provided is accurate and may be used to determine student eligibility.

I grant permission for my child to participate in the Montana Tech Educational Talent Search (TS) Program and receive the free services provided. I hereby certify that the information provided is correct to the best of my knowledge. I release any school, college, or other educational institution to release academic and/or financial aid records or other information to assist in my child’s educational goals. I also authorize TS to release academic and/or financial aid records or other information as necessary to aid in my child’s education. Also, I give permission for Talent Search to take photos of the activities in which my child may be participating.

Please note that program photos may be used in TS newsletters or other TRIO promotional materials (i.e., brochures, slide shows, videos, press releases, and TS Web page).

Parent/Guardian Signature *

Signature Type: Simple Start Over

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Signature: (Type in your full name)

I agree to the terms included.

Date *

Applicant Signature *