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Please fill in each field below. Those marked with an "*" are required. Other fields are optional but highly encouraged so we can help you with as many college readiness services as possible. 
Student Information
First Name *
Last Name *
Middle Name
Date of Birth *
Age *
State *
Local Address *
City *
Zip *
Contact Phone *
Email Address *
Gender Identity *
Social Security Number
Ethnicity *
If you identify as more than one ethnicity, please indicate here
Communication preference: Phone, text, email. List all that apply
How did you hear about MEOC? *
Comfortable reading and writing English *
Are you a US citizen or legal permanent resident? *
Please indicate the status of citizenship *
Please mark yes or no for any special circumstances that apply to you.
Disabled (physical, cognitive, emotional)
Learning Disability (IEP or 504 plan in high school, other LD diagnosis
Currently Incarcerated
Formerly Incarcerated
Currently experiencing homelessness
Current or former Foster Youth (received Foster Care services at some point before age 18)
Veteran/Active Duty Armed Services member OR Spouse/child of an ACTIVE Duty Armed Services member

Financial Information:

 Usually if you are under 24 years old you are considered a "Dependent Student" for FAFSA and other federally-funded programs- like MEOC services; some exceptions apply. Review this webpage to determine your Dependent or Independent FAFSA/ status.

To meet documentation standards for TRiO Grants, Dependent Students MUST include Parent(s) income and household information on this application or provide the information at a later date.

Have you been determined an independent student? (Same as FAFSA regulations *
Household Size (Independent for FAFSA: include those claimed on your taxes only; Dependent for FAFSA: include those claimed on Parent(s) taxes). *
Income Bracket (based on household 2022 TAXABLE Income. Located on Line 15, form 1040). *

Academic Information: Please fill out all information in both bolded sections that applies to you. Leave blank if not applicable.

High School Information

High School status as of this application:
If still in High school or Adult ED programs, which school/program are you currently attending? *
What year did you graduate OR if you are still in high school, what is your expected graduation date? *
Do you want to attend college or vocational school? *

College Information

College status as of this application: *
If already enrolled, list which college(s) you are currently attending:
If already enrolled, list your planned college graduation date:
Did either parent that raised you complete a bachelor's degree? (former Foster Care and Guardianship students mark "No") *

-Participant Needs Assessment-


Academic needs

  • Academic Guidance
  • Admissions Application
  • Vocational Training

List all that apply in the box below: (Please enter one or more options)


Financial Needs

  • Budget Planning
  • Financial Literacy
  • Financial Aid

List all that apply in the box below: (Please enter one or more options)


Personal Needs

  • Career Exploration
  • Housing Information
  • Mental Health
  • Veteran Services

List all that apply in the box below:

Additional Information(Optional): Specialized Services Requests, please be detailed.

Example: List what type of school you want to attend, what you would like to study, or specific questions you have.

Provide any additional information you would like us to know in the box listed below.

Authorization: I declare under penalty of perjury that the information on this form is true to the best of my knowledge. Pursuant to the Family Educational Rights and Privacy Act (FERPA) (20 U.S.C. § 1232g; 34 CFR Part 99), MEOC is authorized to access information deemed necessary to assist me in achieving my educational goals or in meeting the reporting requirements of the U.S. Department of Education, to record pertinent facts regarding my eligibility in the program, services rendered, verification of secondary education completion and post-secondary education enrollment. This information is protected by the Privacy Act, kept confidential and not to be seen unless specifically authorized. A copy of this statement shall serve as such authorization
Participant Signature *
Signature Type: Simple    Start Over
Signature: (Type in your full name)
I agree to the terms included.
Parent/Guardian Signature (for dependent students typically under age 24)
Please select a signature verification type.