Thank you for your interest in our  Pathways for Success/Student Support Services TRIO 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 301-784-5630.
Personal Data:
Last Name *
First Name *
Middle Name
Date of Birth *
Permanent Address *
Permanent Address 2
City: *
State: *
Permanent Zip *
Permanent Phone
Cell Phone Number *
Email Address *
ACM Student ID Number
Gender *
Are you Hispanic/Latino *
Race, Black or African American
Race, White
Race, American Indian or Alaskan Native
Race, Asian
Race, Hawaiian or Other Pacific Islander
College Address if different than permanent address
Have you ever participated in another TRIO program? *
If Yes- what kind of TRIO program?
Educational Data:
Are you enrolled at ACM as a full time student? *
Is this your first time attending ACM?
Course of Study/ Intended Major *
Are you planning to transfer to a 4 year college/university?
If yes, name of school
High School last attended
Year graduated/ last attended
Final High School GPA
Date G.E.D Received (if applicable)
Former College(s) attended
Number of credits earned at former college(s)
Have you already COMPLETED a 2 year degree? *

Eligibility Data:

TRiO programs are required by Federal law to verify applicants' citizenship; family size; income; first generation status; and documented disability to determine eligibility. We do not use this data for any other purpose other than to determine eligibility for the Pathways for Success Program.

I am a U.S. Citizen
I am not a U.S. Citizen, but I have a permanent residency card (copy will be needed)
Did you or your parent(s) file an income tax return for the last year? *
Have you applied for financial aid by completing the FAFSA? *
How many people are in your household (including yourself) *
My or my family's taxable income range: (dependent students or those claimed on their parents' federal income tax are required to use their parents' taxable income even if they have filed as an individual). *
I qualify as a first generation student, as none of my parent(s) or guardian(s) have completed a four-year college degree *
I qualify as a student with a documented disability *


Please answer the questions listed below as you answered on the FAFSA, section 2- Student Dependency Status:

1. Were you born before January 1, 2000? *
2. Are you married? (If you are separated but not divorced, answer "yes.") *
3. Are you serving on active duty in the U.S. Armed Forces? *
Are you a veteran of the U.S. Armed Forces? *
Do you now or will you have children who will receive more than half of their support from you between July 1 2023 and June 30 2024? *
Do you have dependents (other than your children or spouse) who live with you and who receive more than half of their support from you, now through June 30, 2024? *
Since you turned age 13, were both of your parents deceased? *
Since turning 13, were you in foster care? *
Since turning 13, were you a dependent of ward of the court? *
Are you or were you an emancipated minor as determined by a court of law? *
Are you or were you in legal guardianship as determined by a court of law? *
At any time on or after July 1, 2022, were you determined to be an unaccompanied youth who was homeless or were self-supporting and at risk of being homeless, as determined by (a) your high school or district homeless liason, (b) the director of an emergency shelter or transitional housing program funded by the U.S. Depatment of Housing and Urban Development, or (c) the director of a runaway or homeless youth basic center for transitional living program? *
If you answered "YES" to any of the above 1-12 questions, you are considered an INDEPENDENT student. If your answer to all questions above (1-12) was NO, you are a DEPENDENT student (even if you are 18 years old or older). Which type of student are you?
**A Parent/Guardian must sign this form if the student is a DEPENDENT student as indicated above (answered NO to all 12 FAFSA section 2 questions)****
Sign and Submit: Be sure to click the button that says submit signature BEFORE submitting the entire application at the bottom. 
Applicant Signature *
Signature Type: Simple    Start Over
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Signature: (Type in your full name)
I agree to the terms included.
PARENT/ GUARDIAN Signature if selected dependent above
Signature Type: Simple    Start Over
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Signature: (Type in your full name)
I agree to the terms included.

** I certify that the information which I have provided on this entire application is accurate and complete. 

The information provided is true to the best of my knowledge. I authorize the Pathways for Success office to obtain transcripts, academic, financial aid/income documentation, disability and other information as needed. I understand that the staff will monitor academic progress by obtaining grades and other academic data each semester and through communications with faculty and staff. I also give consent for Pathways for Success staff to share information with faculty, other offices on campus, the United States Department of Education, and other TRIO programs. I authorize Pathways for Success program to contact me.