TRIO Talen t Search  Middle School Student Assessment (CCAP)
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First Name *
Last Name *
Current Student or Parent Email *
Current Parent Cell Number *
Current Grade *
Current Middle School *
Attend School *
Class Schedule *
Academic Information: Are you taking any honors/accelerated classes? If yes, check all that apply. If no, skip to the next question.
What are your academic goals *
What are your career interest (ex. what job would you like to have)? *
What are your hobbies or interests (ex. what do you like to do in your spare time)? *
What are your plans after high school? *
What TRIO Talent Search services are you interested in? *
Required
Student Agreement
During this academic year I would like to receive information and assistance with the above identified/requested needs and services as well as accomplish any stated goals. Moreover, I agree to work diligently (hard) towards maintaining academic progress by not falling below a “C” average. I agree to work with the Talent Search (TS) staff to ensure specific actions are fulfilled; specifically, meeting regularly with my TS Advisor and participating in at least two programs this year. ***It is understood that my ultimate goal is enrollment in a program of postsecondary study (i.e., college). My signatures indicates agreement to work towards achieving this plan and fulfilling this agreement.

Student Signature and Date *
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