Student Support Services (SSS) is a federally-funded TRiO Program under the U. S. Department of Education that aids students in graduating from college. Program participants must meet certain requirements set forth by the Department of Education.

To determine eligibility, please complete the entire application and submit required documentation. Incomplete applications will not be considered.

The information you provide is strictly CONFIDENTIAL. Demographic Information will be used in a non-discriminatory manner, consistent with applicable Civil Rights Laws. This information will be used only for Federal and State law reporting purposes.

Please contact our office at (870) 633-4480, Ext 350 if you have questions. 

General Information:
School ID *
Last Name: *
First Name: *
Middle Name:
Date of Birth: *
Describe your primary reason for applying: *
Local Address *
Local Address 2
Local City *
Local State *
Local Zip *
Home Phone
Cell Phone Number: *
Email Address: *

What is your gender? *
Do you identify as Hispanic? *
Do you identify as American Indian or Alaskan Native? *
Do you identify as Asian? *
Do you identify as Black or African American? *
Do you identify as White? *
Do you identify as Hawaiian or other Native to Pacific Islander? *
Eligibility Information:
Are you a US Citizen (or a permanent resident?) *
Do you or will you receive PELL grant funds? *
Parents Educational Level: *
How many people live in your household? *
Family Household Income Range for the previous year:
Please check this box if you have a documented disability on file with the Disability Services office at EACC.
What is your current GPA? *
As of today, how many academic hours have you completed?
Select your biggest academic concern: *
How's your academic standing? *
How many hours are you enrolled in this semester? *
Please choose the biggest obstacle/concern you have in regards to college. *
What are some of your educational concerns? (List items such as taking notes, studying, staying motivated, time management, balance, etc. *

Educational Information:
Which type of diploma do you plan on earning at EACC? *
What is your major area? *
Institution Entry Date *
How do you plan to complete your coursework? *
Do you plan to transfer to a 4-Year College or University? *
If yes, what college are you planning on transferring to?
What other colleges/universities have you attended? When?
What other TRIO Programs have you participated in?
Where did you attend high school? (Name and Location)
When did you graduate or complete your GED? Please list which is applicable.

The SSS Program will provide you with several services.

  • an assigned mentor/advisor to provide you with individual, personal attention
  • educational, personal, and/or career assessment.
  • transfer assistance and campus visits to four-year institutions
  • assistance for students with disabilities
  • tutoring
  • workshops
  • enrichment opportunities
  • educational resources and materials.
  • scholarship information.

In exchange for these services, you are agreeing to abide by each of the following (Please read each statement carefully and click the checkbox to indicate that you agree.)

Agree to attend class regularly and sign-in to my online classes regularly.
See your SSS mentor at least once per month during the fall and spring semesters and upon request by an agreed upon method (phone, in-person, text, email.)
Participate in SSS activities and workshops virtually or in-person
Inform your SSS mentor of any difficulties you might be having that have the potential to negatively impact your academic goals.
Be actively involved in your education

Sign and Submit

If accepted into the SSS Program, I understand that I am committing myself to high academic standards and complete involvement and engagement with my education and goals. I will strive for:


I give SSS staff permission to inquire about my class attendance, class performance, tutoring sessions, grades, and any information that might assist them in helping me to meet my goals. I give my instructors permission to release such information when requested by SSS staff. If I fail to uphold these agreements, I understand that I can be removed from the program.

I authorize SSS staff to gather information concerning all my academic progress and financial aid information (including income tax information) prior to my participation in the program. I understand that this information is used to help determine my eligibility for the program and will be kept strictly confidential.

I grant permission to SSS staff to gather information for follow-up whenever appropriate, including, but not limited to, transfer and progress to four-year institutions. I understand that SSS must release my information for Federal reporting requirements.

I certify that the information I have provided on this application is true and complete to the best of my knowledge. I also agree to provide documentation upon request to verify information.

I hereby authorize the use of my photographic image in any and all publications produced by SSS staff and to use my name and certain information for promoting the SSS program.

I am aware that personal information provided to SSS will be protected under the Federal Education Rights and Privacy Act (FERPA) of 1974. No one will have access to this information unless they work with the SSS Program or are specifically authorized to see the information.

Sign and Submit:
Please provide your electronic signature: *
Please select a signature verification type.