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Thank you for your interest in the Arizona Western College Student Support Services (KEYS) Program. The KEYS Program has a long and rich history of ensuring that all students, regardless of gender, ethnicity, economic status, educational background, and/or disabilities have equal access to higher education, support, and resources necessary to graduate from college. We are a federally-funded program through the U.S. Department of Education.

General Information

According to Federal guidelines, you must also select which race you identify with most. Please select one or more races that apply to you

Select all that apply.

Do you identify as Latino/Hispanic?

Education Details

Student Type
I am seeking a
Do you plan to obtain a 4-year Bachelor Degree?
Do either of your parents have a bachelor degree?
What other support programs have you participated in
(TRIO SSS, Upward Bound, EOC, Talent Search)


Are you eligible to receive Financial Aid based on federal government guidelines?
Do you need special assistance due to a disabling condition?

(i.e. physical disability, learning disability, etc.)

Income Tax Verification (Not Optional)

In addition to being a US Citizen or Permanent Resident, a large percentage of the program participants must be eligible based on family income and size. Therefore, our records must contain certain information for verification of eligibility in the KEYS program. The information you give us will be kept confidential and only used for eligibility purposes. The information is protected by the Federal Privacy Act.

(I am not at least 24 years of age, married, or have dependents, have not served in the US armed forces) *Parent tax information is required as income tax verification
Taxable income can be found on line 15 from the most recent tax year - 1040 Forms
(I am 24 years of age or older, married and/or have dependents, and/or served a veteran of the US Armed Forces, and/or an orphan or ward of the court until age 18.)
Taxable income can be found on line 15 from the most recent tax year - 1040 Forms
Please check the documentation you used to answer the question

Services Needed

What are your needs or concerns?

Please check all that apply.

Insight Questions

Please use complete sentences to answer the questions. The length of your answer should be two to three sentences.

10. Mark the statement that mostly describes your habits right now
11. How many hours PER WEEK do you typically dedicate to doing homework or studying for a test?

Release Information

I hereby apply for services in the TRIO KEYS Program. I certify that all information supplied by me is correct and will be kept confidential and it will be used to determine eligibility and services needed. I give permission to the TRIO KEYS Program staff to check my financial aid and/or I will provide financial information. I give consent for my information, including my name, picture, graduate status, college, major and any awards or scholarships that I receive to be used by the TRIO staff in publications or AWC display cases to promote the success of TRIO KEYS students. I authorize the release of my student academic and financial aid records for the program director to use for reporting purposes to the Department of Education and determine eligibility.

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