CAMP Application. Housing Requested: Yes No If Yes, Date Housing was requested: / / TAMIU Admissions Application

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1 CAMP Application College Assistance Migrant Program (CAMP) Texas A&M International University 5201 University Boulevard Laredo, Texas Phone: (956) Fax: (956) Web: NOTE: This does not replace the TAMIU application available from ******************************************************************************* General Qualifications: Applicant must Be a citizen of the United States of America or legal resident Be a migrant or seasonally employed agricultural worker or an immediate family member of a migrant or seasonal migrant worker who has: Spent a minimum of 75 days during the past 24 months as a migrant or seasonal farmworker; or Participated in, or been eligible to participate in, the Chapter I Migrant Education Programs or NFJP section 167 WIA. Be enrolled or admitted for enrollment as a full time student at Texas A&M International University Not be beyond the first academic year of a program of study Need academic, financial, or transitional support in order to successfully complete his/her bachelor s degree at TAMIU ******************************************************************************* FOR CAMP OFFICE USE ONLY: TAMIU Student ID: Housing Requested: Yes No If Yes, Date Housing was requested: / / TAMIU Admissions Application CAMP Application High School Transcript Resume Open Ended Responses TSI Access Permit Form Certificate of Eligibility (COE) FAFSA Verification of citizenship/legal resident: Source: Staff: Date:

2 PERSONAL INFORMATION: : Last, First, Middle Initial SSN: Date of Birth: / / Age: Gender: Female Male Mailing Address: Street/Box No. City State Zip Code I plan to enroll at TAMIU: Fall Spring Summer 20 Primary Phone: ( ) Secondary Phone: ( ) Address: I am a: U.S. Citizen Legal Resident Neither Student currently living: With both parents Mother Father Other Parent(s) Marital Status (check one): Married Separated/Divorced Single Widowed Father s : Current Occupation: Highest level of education completed: Elementary Middle School High School College Mother s : Current Occupation: Highest level of education completed: Elementary Middle School High School College EMERGENCY CONTACT : Phone: Relationship: HIGH SCHOOL INFORMATION What High School will you be graduating from? Are you classified as a Migrant Student in your High School? Yes No If yes, provide copy of Certificate of Eligibility. If no, when was the last time you or your parents engaged in migrant or seasonal farm work? (Month/Year) /

3 Anticipated Class Ranking ( out of ) Grade Point Average upon graduation. Graduation Plan: Regular Recommended Distinguished/Honors Other School Counselor: Counselor s Phone Number: COLLEGE ADMISSION INFORMATION Have you applied for admission to TAMIU? Yes No Undecided Have you taken the ACT/SAT? Yes No If yes, date? Expected major at TAMIU (indicate if Undecided)? Do you plan to complete your four-year degree at TAMIU? Yes No Unsure Have you applied for financial aid through FAFSA? Yes No Unsure NOTE: You must include TAMIU as a recipient of your FAFSA information. School Code Have you taken college credit courses elsewhere? If yes, where? How many college/ap credits will you have earned prior to your 1st semester at TAMIU? NOTE: Provide an official transcript to TAMIU from each college/university where you have earned credit. COLLEGE READINESS Have you taken the TSI? Yes No If yes, date/site? / HOUSING While attending TAMIU, where do you plan to live? On Campus Off Campus Please be advised that housing is assigned on a first-come first-served basis. RESUME Please attach a RESUME with this application using the template provided. OPEN ENDED RESPONSES Provide open ended responses on (1) your farmworker experience, (2) your academic and career goals, and (3) who has had the most influence in your decision to pursue post-secondary education and why. CERTIFICATION I certify that all the information provided in this application is complete and accurate to the best of my knowledge. If I am admitted to TAMIU-CAMP, I agree to observe all rules and regulations of the University and the program. I understand that failure to do so may result in my termination from CAMP. NOTE: Your application is not considered complete until all required documents are received. Student s Signature Date If the student is under 18 years of age, a parent s signature is required. Parent s Signature Date

4 AUTHORIZATION TO RELEASE INFORMATION Texas A&M International University College Assistance Migrant Program I hereby authorize Texas A&M International University to request and receive any information necessary to verify program eligibility, employment, academic or other information. STUDENT Date of Birth SSN Student s Signature Parent Signature Date (Required if applicant is under 18 years of age) PARENT SSN Date of Birth Parent s Signature Date PARENT SSN Date of Birth Parent s Signature Date

5 ELIGIBILITY VERIFICATION CHAPTER I MIGRANT PROGRAM Texas A&M International University College Assistance Migrant Program Please verify eligibility of participation in CHAPTER I Migrant Education (MEP) or WIA 167 Program by submitting a copy of the most recent Certificate of Eligibility. If you need more information, please call the TAMIU-CAMP office at (956) SSN I hereby authorize the release of the requested information. Applicant s Signature DATE COE received by Date

6 I,, grant permission to the Texas A&M International University Testing Center to retrieve my TSI test score from the College Board s Cross Institution ISR Reporting system. I understand that these scores will be used to determine my college readiness. Signature Date The following information is needed to retrieve scores: ID Used for Testing Date of Birth Testing Site 5201 University Blvd Office University Success Center 201 Fax Laredo, Texas 78041

7 RESUME Street Address City, State, Zip Phone EDUCATIONAL OBJECTIVE EDUCATION High School Graduation Date GPA Rank: ACT: SAT: HONORS AND AWARDS (include date and year on each) SCHOOL INVOLVEMENT Clubs, organizations, athletics (include date and year on each) COMMUNITY SERVICE ACTIVITIES (include date and year on each) WORK EXPERIENCE (include date and year on each) REFERENCES (2 or 3; include title/phone/ address)

8 Open Ended Responses Information on your farmworker experience: How old were you when you participated in farm work? What other family members participated in farm work? What state/states did you travel to? What you recall most about your experience? Information on your academic and career goals: What degree program do you plan to follow? Why did you choose that degree program? Where do you see yourself in six years? Who has had the most influence in your decision to pursue post-secondary education? ( and title: Why?