Submit Your 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. If you have any questions, please call our office at 406-791-5915.

General Information:

Last Name: *

First Name: *

UProvidence Student ID#: *

Date of Birth: *

Cell Phone Number: *

UProvidence Email Address: *

Eligibility Information:

To determine eligibility, you need only fit one of the following categories, but can fit under multiple. Please answer to the best of your knowledge.

Are you First Generation? This means that neither parent (or legal guardian) has received a Bachelor's Degree or 4-year equivalent prior to you turning 18.

Are you Income Eligible? Income Eligibility is based on household size. Do you come from a low income family?

An example of what we mean by Low Income Household is as follows: A household size of 1 that has a yearly income of $50,000 would be ineligible based on Income Eligibility. However, a household size of 6 making $50,000 a year would be eligible, as it would be harder for 6 people to live on just $50,000 a year. (This is only an example and may not reflect the actual amounts that we are given each year to judge eligibility.)

Do you have a Documented Disability? You do not need to tell us what this disability might be. This can be any disability, including but not limited to learning, physical, mental, or temporary as recognized by the Americans with Disabilities Act and/or by Section 504 of the Rehabilitation Act.

First Generation: *

Income Eligibility *

Do you have a Disability? You need not let us know what it is via this application. *

Sign and Submit:

Applicant Signature *

Please select a signature verification type.

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. By submitting this application you also agree to give permission for the TRIO Student Support Services program to view your full student records to determine eligibility. This includes but is not limited to biographical information, FAFSA information, and class schedule.