Thank you for your interest in our Student Support Services Veterans (SERVE) 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 (352) 381-7191.

Section One: Student Information:
Last Name: *
First Name: *
Middle Name:
Date of Birth: *
Santa Fe College School ID# *
Gender *
Address: *
Address 2:
City: *
State: *
Zip Code: *
Home Phone *
Cell Phone Number: *
Email Address: *
May we send occasional TEXT MESSAGES with program information to you cell phone number? *

Racial/Ethnic Background

Per U.S. Department of Education reporting requirements, TRIO Student Support Services must collect and report gender, ethnicity, and race information for each program participant with only the responses provided below. 

Please select all that apply.

Ethnicity: Hispanic or Latino*
Race: American Indian or Alaskan Native*
Race, Asian*
Race, Black or African American*
Race: Hawaiian or other Native to Pacific Island*
Race: White/Caucasian*

Academic Information:
Highest Level of Education *
Do you have a previous degree from another institution?
What is your current major? *
What is your current degree track? *
Credit hours completed *
My academic goal includes earning a bachelor's degree *
I plan to transfer to a 4-year college/university. *
Current GPA: *

Section Two: Eligibility Information

Funding is provided by the US Department of Education and requires specific documentation of household income level and educational background for enrollment into the Student Support Services Program.  The information is protected by the Family Rights and Privacy Act and will be held in strict confidence.  The information is used to determine if the student is eligible to participate in the SSS SERVE Program.

Are you a U.S. citizen? *
Eligible to receive Federal student aid *
US Permanent Resident *
I am service connected *
Do you have a documented physical or learning disability? *
Are you registered, or do you plan to register, with SF's Disability Resource Center? *
What is the highest level of education completed by your biological/adoptive parent 1? *
What is the highest level of education completed by your biological/adoptive parent 2? *
Branch of service *
Discharge Type *
National Guard/Reservist with active duty time. Orders required to be eligible. *
VA Chapter Benefits *

Family Income Range: *
How many people in your family? *
Did you file a 2021 tax return? *
What was your taxable income in 2021, as shown on tax form 1040, line 15? *
If you filed a 2021 tax return you MUST enter a taxable income amount or the application will not be processed.

I acknowledge that all of the information included in the  Income Verification section is correct  to the best of my knowledge.

Section Three: Student Support 

In which of the following areas would you like to receive services to support you academically? Please check all that apply.

Academic Support/Tutoring*
I am undecided on my college major. *
I have significant responsibilities (children, siblings, spouse, etc.) *
I have significant financial responsibilities beyond the cost of college. *
I plan to work 20+ hours per week while attending school. *
Sometimes I feel like I do not belong. *
I have been out of school for over three years. *
I would like help creating study habits. *
I am afraid of failing a college course. *
I would like grant aid.*

Statement of Interest
I am seeking an A.A./A.S Degree at Santa Fe College.
Why are you interested in becoming a Veterans Student Support Services participant, and how can we help you reach your goals? *

Section Four: Student Agreement

If I am accepted into Student Support Services, I agree to the following:

·       I will meet with my SSS Academic Coach at least THREE times per semester.

·       I will develop an Individual Student Success Plan with my SSS Academic Coach each semester.

·       I will take ownership of academic success and personal growth.

·       I will be proactive in seeking help.

·       I will attend at least one SSS workshop or academic-enhancement event each semester.

·       I will attend required class sessions.

·       I understand that to be considered an SSS participant and to be considered for grant aid, I must participate in the program as outline above.

Do you agree to the terms listed above? *

I understand that to be eligible for Student Aid I must abide by the Student Agreement, and that students in their first or second year of college will receive priority. *

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.
Sign and Submit:
Please provide your e-signature below: *
Please select a signature verification type.
I agree to the terms included.

Student Support Services is committed to an environment that embraces diversity, respects the rights of all individuals, is open and accessible, and is free of harassment and discrimination based on, but not limited to, ethnicity, race, creed, color, religion, age, disability, sex, marital status, national origin, political opinions or affiliations, veteran status and/or sexual orientation.

                                                                                             EA/EO notice

                                                 Inquiries regarding non-discrimination polices should be directed to:

Lara Zwilling, Equal Access/Equal Opportunity Coordinator ● 3000 NW 83rd Street, R-Annex, Room 113, Gainesville, Florida 32606 ● (352) 395-5420 ●

Updated for the 2022-2023 school year. Printing of this document was made possible by a federally funded Student Support Services Grant.