Click here to download the TRIO SSS application

Please attach the following to your application before submitting it to our office:

  1. Proof of Disability (if applicable)
  2. Proof of Income: 
    1. If you are a dependent student according to financial aid (see page 2 of application), we need your parents'/guardians' proof of income from the previous year
    2. If you are an independent student according to financial aid (see page 2 of application), we need your proof of income from the previous year
    3. You may submit one of the following as proof of income:
      1. A copy of your/your parents' most recent signed income tax return (1040) or proof of unemployment to verify taxable income
      2. signed statement stating your/your parents' most recent taxable income and number of family members for that year (note: our low-income levels are based on taxable income, please do not include your adjusted gross income or total income on your signed statement).
  3. Personal Statement (if it wasn't written on the application)
  4. Letter of Recommendation (optional)

Submitting your Application

You can return the application to us in one of several ways,

  1. Bring it by Derrick Tate's office in the Teacher Education Center, room 307 (SHSU campus)
  2. Fax it to 936-294-3802 (if faxing, please call 936-294-1694 to verify it is received)
  3. Scan and email it to 
  4. Mail it to:
    TRIO Student Support Services
    ATTN: Kelly Stuckey
    Box 2119 SHSU
    Huntsville, TX 77341-2119

You will be notified if you are accepted into the program.

If you have any questions, please call Derrick Tate at 926-294-1694.


In accordance with the Privacy Act of 1974 (Public Law No. 93-579, 5 U.S.C. 552a), you are hereby notified that the Department of Education is authorized to college information to implement the Student Support Services Program under Title IV of the Higher Education Act of 1965, as amended (Pub. Law 102-325, Sec. 402D). In accordance with this authority, the Department receives and maintains personal information on participants in the Student Support Service program. The principal purpose for collecting this information is to administer the program, including tracking and evaluating participant progress. Providing the information on this form, including a social security number (SSN) is voluntary; failure to disclose a SSN will not result in the denial of any right, benefit or privilege to which the participant is entitled. The information that is collected on this form will be retained in the program files and may be released to other Department officials in the performance of their official duties.