Thank you for your interest in the UNM Valencia 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 (505) 925-8711.

General Information:

First Name *

Middle Name

Last Name *

Sex *

Preferred Name

Preferred Pronouns

Date of Birth *

Marital Status *

Permanent Address *

Permanent City *

Permanent State *

Permanent Zip *

Cell Phone *

Home Phone *

UNM Email Address *

Nine Digit Banner ID *

Are you a U.S. Citizen? *

Are you a Permanent Resident? *

THE USDE REQUIRES INSTITUTIONS TO COLLECT DATA ON RACE AND ETHNICITY. Please choose from below: If Hispanic, MUST choose option for race.

Are you Hispanic or Latino? *

Race, White *

Race, Black or African American *

Race, Hawaiian or other Native to Pacific Island *

Race, American Indian or Alaskan Native *

Race, Asian *

High School Information:

High School Attended *

Date Graduated *

High School GPA *

GED *

GED Date

Academic Information:

Current College Grade Level *

Current Total Number of College Credits *

When did you first enroll in classes? *

Of which year? *

How many credits are you currently enrolled in this semester? *

Cumulative GPA *

What is your academic standing? *

What is your degree plan? *

UNM Valencia Major *

What is your career goal? *

Are you working towards your first 2-year degree or 4-year degree? If no, which was your previous degree? *

Academic Need *

Disability Disclosure:

Did you have an IEP in High School? *

Do you have a documented Disability? *

Have you contacted Equal Access (505-925-8910) regarding the disability? *

Family and Financial Information:

Did either of your parents receive a Bachelor's Degree before your 18th birthday? *

Do you receive AFDC, food stamps, TANF, Social Security, or other assistance programs? If so, which? *

Have you completed the FAFSA? *

How many people in your household at home? *

Family Income Range *

Most current IRS 1040

Additional Information

Referred by : *

Please write a paragraph below explaining why you wish to become a TRIO participant and how we may help you meet your academic goals: *

Please select all the Student Support Services/TRIO services that you are interested in:

Assistance with enrollment

Assistance choosing a major/career

Cultural experiences or events

Transfer assistance

Assistance in applying for financial aid

Developing study skills

Assistance adapting to college life

Time management

Financial literacy

Test Preparation

Problem solving

Campus resources

Test Anxiety

Tutoring

Mentoring

Job seeking skills

Resume development

Community resources

Help with low grades

Adjusting to college after being out of college for more than 5 years

English proficiency

*

Please select a signature verification type.

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.