Morehead State University

Student Support Services Application

Thank you for your interest in the Morehead State University Student Support Services program!  Please complete this application as thoroughly as possible.  This application takes about 10-15 minutes to complete and must be completed in one setting. Please review the required information before completing your application to better assist you with this process. 

If you have questions or need additional information, contact us at:

Student Support Services

2nd Floor Allie Young

(606) 783-2614
STUDENT INFORMATION
Which Program are you interested in? *
Last Name: *
First Name: *
Middle Name
MSU ID *
Date of Birth: *
Gender *
Address: *
City: *
State: *
Zip Code: *
County
Cell Phone Number:
Opt Out of SSS Text Messages
Home Phone
Do You Plan to Live on Campus or Commute?
Email Address: *
Are you interested in living in the SSS Living Learning Community (LLC)
ETHNICITY
Race, Hispanic *
Race, American Indian or Alaskan Native *
Race, Asian *
Race, Black or African American *
Race, White *
Race, Hawaiian or other Native to Pacific Island *
ELIGIBILITY 
Did Your Mother Graduate from a University with a 4-Year, Bachelors’ Degree? (Not including Community College, Diplomas, or Certificate programs) *
Did Your Father Graduate from a University with a 4-Year, Bachelors’ Degree? (Not including Community College, Diplomas, or Certificate programs) *
Are You a U.S. Citizen? *
Do You Have a Documented Disability? *

TRIO PROGRAMS YOU HAVE PARTICIPATED IN:
Upward Bound/Upward Bound Math Science (UB/UBMS)
Talent Search (TS)
GEAR UP
Educational Opportunity Center (EOC)
Student Support Services (SSS)
If you were previously in Student Support Services (SSS) where?
EDUCATIONAL INFORMATION
Have you registered for SOAR at MSU?
If YES, Date attending/attended
College Level *
Degree Program *
Major of Study *
Have You Attended College Elsewhere?
If YES, Where? (Do Not Include HS Early College)
Date of High School Graduation *
Name of HS Attended *
Received GED

FAFSA COMPLETION

I have completed the FAFSA for:
2023-2024
2024-2025
2025-2026

FINANCIAL INFORMATION

*Please Submit Your Family's Most Recent Income Tax Return Showing TAXABLE INCOME
Number in Household: *
Family's Taxable Income *
Student's Taxable Income *
MSU Classifies Me as an Independent Student
My Family DID NOT File Income Taxes
Parent/Guardian Signature (To Verify Income) *
Signature Type: Simple    Start Over
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Signature: (Type in your full name)
I agree to the terms included.
By signing below, I confirm that all information on this side of form is true & correct and/or verify independent status. 
Student Signature *
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Signature: (Type in your full name)
I agree to the terms included.

AUTHORIZATION

I authorize the SSS Program to obtain, copy, review, and discuss records including:

  1. High School Transcript
  2. Transcripts from Other Colleges
  3. Financial Aid Records
  4. Standardized Test Scores
  5. Course Registration for Each Semester
  6. Academic Progress
  7. Final Grades and Transcripts
  8. Disability Documentation

I authorize use of my name and photograph to be published in Student Support Services' publications. I also certify that all of the above information is correct. Complete of this application does not guarantee acceptance into the program.
Student Signature *
Signature Type: Simple    Start Over
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Signature: (Type in your full name)
I agree to the terms included.

Student Support Services

Academic Need Questionaire
What obstacle(s) could hinder or prevent your academic success. Mark all that apply. (Required Question*)
Low self-esteem
Test Anxiety
Lack of Money
Too Shy
Always worrying
Problems at Home
Alcohol and/or drug problems
Transportation problems
Recurring health concerns
Family Medical Problems
Taking things to seriously
Easily distracted
Poor time management skills
Housing Problems
Dealing with bill collectors
No support from family
Feeling depressed or sad
Separation or divorce
Trouble sleeping
Poor Study Habits
Taking the wrong classes
Disorganized notes
Poor reading skills
Poor math skills
Afraid to speak up in class
No close friends at MSU
Additional Questions
Have you ever been in foster care?
Are you currently homeless?
Give us a snapshot of you life right now- tell us about YOU.
What fears do you have about starting MSU or being a college student?
What are the main issues that you face on a regular basis? (Ex: Need Health Ins. or Transportation)
What support do you have at home? Who is in your corner? Who has your back?
What brought you to Morehead State University? What are your future plans and goals?
What is most appealing to you about the services and resources Student Support Services provides?

STUDENT SUPPORT SERVICES CONTRACT

MOREHEAD STATE UNIVERSITY

As a participant in Student Support Services: 

  • My goal is to earn an Bachelor's Degree.
  • I will contact my SSS Counselor at least twice a month and more often if necessary. 
  • I will attend at least TWO workshops each semester.
  • I will attend tutoring sessions if advised by my SSS Counselor.
  • I authorize the use of my name and photograph to be publicized in SSS publications.

Qualifications for receiving SSS Grant Aid:

  • Student must receive the Pell Grant
  • Student must be in their first or second year of college
  • Student must maintain a GPA of 3.0 or higher each semester 
  • Student must contact SSS Counselor at least twice a month
  • Student must attend at least TWO workshops a semester
Student Signature *
Signature Type: Simple    Start Over
Click here to start signing.
  • Pencil
  • Reset
Signature: (Type in your full name)
I agree to the terms included.
MSU ID *