Thank you for your interest in our Student Support Services 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. 

If you have any questions, please call our office at 870-972-2320.

 Before you begin, please attach the following files:
Autobiographical Statement:
Unofficial Transcript:
Income Verification (FAFSA Submission Summary):

*If you cannot attach them to this form, please email them to sss@astate.edu. Your application is not considered complete until these have been received.

Personal Information:
First Name: *
Middle Name:
Last Name: *
Date of Birth: *
Race/Ethnicity:
Gender:
U.S. Citizen?: *

Contact Information:
Email Address (Use @smail.astate.edu if already enrolled): *
Cell Phone Number: *
Cell Phone Opt Out (SSS may use text messages to contact participants. If you would NOT like to receive text messages, check this box.):
Address: *
Address 2:
City: *
State: *
Zip Code: *
Housing: *

Eligibility:
Have you taken Making Connections or another "Freshmen Studies" course?
Have you been a part of a TRIO program in the past?: (AVID, Upward Bound, Talent Search, etc.) *
Do you have a Registered Disability? *
Mother's Highest Level of Education: *
Father's Highest Level of Education: *
Are you receiving Pell Grant? *
List any other types of financial aid that you will receive (Federal Work Study, Veteran's Benefits, Arkansas Workforce, Privately Funded or Institutionally Funded Scholarships, etc.)

Academic Information:
ASU ID:
(Optional) Intended Major:
Which high school did you graduate from?: *
High School Completion: *
Year Completed High School: *
ACT Math Score: *
ACT Reading Score: *
ACT Composite Score: *
High School GPA: *
Additional Comments:

Sign and Submit:
*
Signature Type: Simple    Start Over
Click here to start signing.
  • Pencil
  • Reset
Signature: (Type in your full name)
I agree to the terms included.
Terms of Submission:
 By submitting this application, you acknowledge that all of the above information is correct and accurate to the best of your understanding.