Step 4: Student Performance Agreement
TRIO SSS provides opportunities for academic development, assists students with college requirements, and motivates students towards successful completion of their postsecondary requirements. The goal of SSS is to increase the college retention and graduation rates of its participants. This agreement shows the expectations Northwest Missouri State University’s TRIO SSS has of its participants to help meet these goals. Students accepted in our program will participate for up to 6 years or until graduation from Northwest Missouri State University, whichever comes first.
Summer Bridge Scholar Commitments
Please read and check the boxes to demonstrate your commitment:
I will arrive on July 30, 2023 and stay for the entire TRIO Summer Bridge Scholar program located on the campus of Northwest Missouri State University and participate in all academic, social and scheduled activities.
Attendance Agreement Yes No
I will have no other time commitments, during the TRIO Summer Bridge program. This includes, but is not limited to personal or work commitments, summer programs or tryouts during July 30 - August 1, 2023.
Commitment Agreement Yes No
I will comply with all rules, regulations and policies of Northwest Missouri State University.
Compliance Agreement Yes No
I have completed the 2023-2024 FAFSA.
FAFSA Agreement Yes No
I will enroll in and successfully complete TRIO's course for bridge students during the Fall term.
Course Enrollment Agreement Yes No
I understand that at the completion of the 2023-2024 academic year, I will receive a $1000 scholarship that applies to my 2024-2025 school year, if I meet the following criteria:
I have participated in all summer bridge activities.
I am in good academic standing./li>
I have actively participated in the TRIO SSS program (attended coach meetings, peer mentor meetings, and SSS hosted events).
Scholarship Agreement Yes No
Student Member Responsibilities
Please read and agree to demonstrate your commitment:
Confidentiality Agreement
Northwest Missouri State University Academic and Professional Waiver
I give my permission to the TRIO and Student Support Services professional staff (SSS assistant director, academic success coach, financial literacy coordinator) to do the following:
I authorize the release of academic, financial and any other information in my SSS files unless and until this authorization is specifically withdrawn in writing by me.
I authorize the release of my records to and from when necessary: parents/guardians, instructors at Northwest, the Office of Equity and Accessibility, Vocational Rehabilitation counselors, Wellness Center and other professional personnel when needed.
I authorize the release of academic records from the Registrar’s Office, Advisement Office, Admissions Office and Student Success Center for semester reports that include and are not limited to grade reports, class enrollment, tutoring reports, graduation reports, SAT/ACT Scores, transcripts (high school, other post-secondary institutions, Northwest).
I authorize SSS staff to receive information from and communication with any Northwest departments and other Northwest administrators and on my behalf when the sole purpose is to promote educational opportunities for me.
Yes No
Student with Disabilities Waiver
I Student with Disabilities Waiver
- Select -
Do
Do not
Does not apply to me
give my permission to the TRIO Student Support Services professional staff to share limited disability-related information about me with my TRIO SSS Peer mentor so that they may adequately assist me in my academic progression and success at Northwest Missouri State University.
By submitting this form, I certify that all the information I have typed into this form is correct and I understand that any false information (or omissions) in the contract agreement or its supporting documents will be sufficient grounds for TRIO SSS application denial.
To retain a copy of this application for your records, PLEASE PRINT THIS PAGE NOW!
Northwest Missouri State University TRIO SSS Office Administration Building 372 - West Wing 800 University Dr. Maryville, MO 64468
Phone: 660.562.1862 Fax: 660.562.1631 Email: ssswebp@nwmissouri.edu