Yavapai College : SSS Eligibility Form

	yc website people courses
	maps e-services\| contact us\| campuses\| calendars\| blackboard\| a - z index\|

Student Support Services Eligibility Form

* Required Fields Form Instructions Please complete and submit this form to Student Support Services (SSS). One of the SSS staff members will then contact you. PLEASE NOTE: To be eligible for SSS, you must first be seeking a degree and enrolled in 9 credit hours. Check as many of the following eligibility requirements that apply to you.
Your Personal Information
First Name:*
Last Name: *
Home or Cell Phone Number: * (include area code when necessary)
Email Address: *
Do you check the email address regularly? *
What degree are you seeking?*
Which YC Campus do you attend? (check only one) *	Prescott Campus Verde Valley Campus
Eligibility Requirement Details
Please check all that apply: *	You are seeking a degree and enrolled in at least 9 credits (you must check this box) Neither of your parents has a bachelor’s degree You are the recipient of a Pell Grant or meet financial aid guidelines You have a documented physical or learning disability
Specific issues you wish to describe:
Please take a moment to check over your entries. When you are satisfied with your answers press the submit button above. Thank you.