Submit Your Application

Cassville SSS Application

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 (417) 847-1706.

Visit our webpage for more program information.

General Information:

Last Name: *

First Name: *

Middle Name:

Date of Birth: *

Social Security Number: *

Marital Status: *

Sex: *

What is your Crowder ID#?

Ethnicity (choose one): *

Race (choose one): *

Are you a U.S. Citizen? *

If you answered 'No' above, are you a Permanent Resident?

If you answered 'Yes' above, please enter your Permanent Resident Alien Number:

Select your primary reason for applying: *

Address: *

Address 2:

City: *

State: *

Zip Code: *

Home Phone:

Cell Phone Number: *

May SSS text you at the above number? *

Personal Email Address: *

Academic Info:

I am currently enrolled in: *

What is your current academic level? *

How many classes are you taking? *

Have you completed your FAFSA for this academic year? *

How did you learn about SSS at Cassville?

High School attended (if applicable):

Are you a GED/HiSet Recipient? *

What year did you graduate or receive your GED? *

Future educational goals: *

Academic Need: Please check all that apply.

My high school GPA was less than 2.5

My high school graduating class had less than 100 students

My high school did not have, or I did not participate in, college prep coursework

I was under an IEP in high school

English is my second language

I am currently a single parent

It has been at least 5 years since I've been in school

I am unsure what I want to major in

I am going though an external funding agency (VR, TRA, PIC, DFS, etc.)

I received a GED or HiSet

I am pursuing Pre-Nursing, Nursing, or Teacher Education

I have previously participated in a TRIO program:

Other Academic Need:

Family Information:

Mother's Educational Level: *

Father's Educational Level: *

Which parent did you regularly reside with and receive support from during your childhood (up to 18)? *

How many people in your household (including yourself) live at home? *

STUDENT INCOME: If you filed taxes, please enter your TAXABLE INCOME from your most recent tax return here.

PARENT(S) INCOME: This is only required if you (student/applicant) are a dependent student (23 years old or younger). Enter parent(s) TAXABLE INCOME from the most current tax return here.

Check here if you (Student/Applicant) did not file taxes:

Check here if your parent(s) did not file taxes:

If you choose to do so, you may upload your most recent IRS 1040 here. This will ensure we receive the correct TAXABLE INCOME amount.

Sign and Submit:

Applicant (Student) Signature: *

Signature Type: Simple Start Over

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Signature: (Type in your full name)

I agree to the terms included.

Parent Signature (required only if parent TAXABLE INCOME is submitted and you (student/applicant) are dependent):