Texas Tech University

Pre-Application Questionnaire

To check your Eligibility, Please fill out the Pre-Application Questionnaire.

Fields Marked with * ARE Required.

Size of
Family Unit
Taxable Income Level
(Not Gross Income)
1$18,090
2$24,360
3$30,630
4$36,900
5$43,170
6$49,440
7$55,710
8$61,980

First Name: *
MI:
Last Name: *
Cell Phone Number: *
(Format xxx-xxx-xxx)
Email Address: *
Gender: * Male
Female
 
Student Classification: * FR (0-29 hrs)
SO (30-59 hrs)
JR (60-89 hrs)
SR (90+ hrs)
 
Citizenship Status:* U.S. Citizen
Permanent Resident
Non-Resident
 
Did either one of your natural or adoptive parents/guardians graduate from a 4-Year University?* Yes
No
I don't know
 
Do you have a documented physical or learning disability?* Yes
No
 
Have you registered with TTU's Student Disability Services (SDS)?* Yes
No
 
Status* I am an INDEPENDENT. (1) I am married OR (2) am over the age of 24 OR (3) have served in the military OR (4) I have a child OR (5) I was in Foster Care at the age of 13 or older.
I am a DEPENDENT. (1) I am not a parent, AND (2) I am not married, AND (3) I am under the age of 24, AND (4) I have not served in the military (Your parents must fill in and sign the application).
 
No. of Family Members in Household (including yourself): *
Family Taxable Income (From last year's Income Tax Forms): *
(Use only numbers)
TRIO Income Level (Please see chart above):*

I verify that all information is 100% true and accurate to the best of my knowledge.


Signature: *
Today's Date (click to select): *
(mm/dd/yyyy format only)