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Student Support Services

Shawnee State University Student Support Services Program Application

Must be a US Citizen Seeking a Four Year Degree from Shawnee State University

Note: You MUST bring a copy of your (or parent’s) latest tax return.


All information you supply will be held in strict confidence.

This application cannot be considered if all information is not included.

Student Support Services at Shawnee State University does not discriminate on the basis of race, religion, color, national origin, sex, age, sexual orientation, or disability with respect to access, employment programs, or services.

 

Applicant Information













What schools other than SSU have you attended BEYOND high school?



Household Information

Other Information
What is the highest level of education COMPLETED by the parents you grew up with?
Service Information
Check all of the following services that may interest and/or benefit you.
Statement of Rights and Responsibilities
Student Publicity Release
I agree that if I am accepted into the Student Support Services Program, the staff may include my name and/or picture in publications, including their website. This publicity highlights student accomplishments and participation in campus and SSS activities.
Release of Information
I certify that the information I have provided on this application is, to the best of my knowledge, complete and accurate. Furthermore, I understand that by applying for the SSS Program, I authorize SSS staff to obtain financial and academic records or data pertinent to my participation from Shawnee State University and other sources, and to release information to the United States Department of Education, TRIO programs. The SSS staff also has my permission to communicate verbally or otherwise with staff, faculty, and/or off-campus professionals on my behalf. I understand that I may withdraw this release at any time by indicating my withdrawal in writing or by email to the Student Support Services.


After we receive your application, you will be notified when to come in for your initial interview.
Personal Academic Inventory


Directions: Please read the following questions carefully. Answer each question as honestly as you can. This is NOT a test. If you have any questions about any of the following items, please request assistance before responding. For items 1-15, you will need to place only the number that corresponds to your response in the blank space provided at the extreme right side of the question.
Career Inventory

If you marked 3 or 4 for the above questions, would you be willing to:

Student Support Services

Contact Information

Student Support Services
ATC Building, 2nd floor TRiO Center
Shawnee State University
940 Second Street
Portsmouth, OH 45662

Phone: (740) 351-4777
FAX: (740) 351-3419
Hours: Monday – Friday 8am to 5:30pm

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