A&M-Texarkana 2017 Workforce Training Grant Application

TEXAS A&M UNIVERSITY-TEXARKANA

Extended Education
& Community Development
7101 University Ave, UC234
Texarkana, TX 75503
(903) 334-6683

A&M-Texarkana 2017 Workforce Training Grant

Deadline to Apply: January 23^rd

Requirements for this grant

This competitive grant is for those with demonstrated financial need.
Those applying must prove need with:

A financial hardship letter outlining need
Ability to commit to and complete course of study
Copy of most recent pay stub or financial aid award if Pell eligible

Contact Information


	Last Name:
	First Name:
	Middle Initial
	Address:
	City:
	State:
	Legal State of Residence:
	Zip Code:
	Home Phone Number:
	Work Phone Number:
	Cell Phone Number:
	Email Address:
	Number of Dependents:
	Employer:
	Are you a Student?:	Yes No
	Prior Healthcare Employment::	Yes No
	If Yes, Number of years:

Academic Information

Enter Financial Hardship Letter:

Are you related to any member of the Texas A&M System Board of Regents? These relationships include one of the following: Please select one:

Not related
Regents's - spouse, spouse's child, spouse's parent, child's spouse, parent's spouse
Regents's - spouse's brother or sister, spouse's grandparent,
spouse's grandchild, brother or sister's spouse, grandchild's spouse
Regents's - parent, daughter, son
Regents's - brother, sister, grandparent, grandchild
Regents's - great-grandparent, great-grandchild, uncle or
aunt(brother or sister of parent), nephew or niece(son or daughter of
brother or sister)

A list of the current Texas A&M University System Board of Regents members can be found at http://tamus.edu/regents/bios/.

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BY CHECKING THIS BOX, I CERTIFY THAT THE ABOVE INFORMATION IS CORRECT AND THAT SUBMISSION OF FALSE OR MISLEADING INFORMATION ON THIS APPLICATION MAY DISQUALIFY ME FROM RECEIPT OF ANY GRANT AWARD(S) AND REQUIRE ME TO REPAY ANY FUNDS THAT ARE AWARDED ME BASED ON FALSE INFORMATION. I ALSO UNDERSTAND THAT, IF I AM AWARDED ANOTHER GRANT AT A&M-TEXARKANA OR RECEIVE OTHER TYPES OF FINANCIAL AID, I MAY BE REQUIRED TO REDUCE OR FORFEIT ALL FUNDS I AM AWARDED FROM THIS GRANT.

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I GIVE PERMISSION FOR INFORMATION ON THIS GRANT TO BE RELEASED TO THE DONAR OR POTENTIAL DONORS OF ANY GRANT(S) FOR WHICH I MAY BE ELIGIBLE. I ALSO AUTHORIZE PUBLICATION OF ANY AWARD THAT I MAY RECEIVE.

State law requires that you be informed of the following: (1) you are entitled to request to be informed about the information about yourself collected by use of this form (with a few exceptions as provided by law); (2) you are entitled to receive and review that information; and (3) you are entitled to have the information corrected at no charge to you. For more information see our Privacy Statement.