EOP Eligibility Form

Timer

--:--

* = required field

Some content may be updated based on selection

EOP Eligibility Form

First Name

Last Name

OCC ID

Gender

Address

City

State

Zip code

Phone number

e.g. (999) 999-9999

Parent/Guardian Phone number

e.g. (999) 999-9999

Preferred Communication Method

Are you a NY State resident?

Are you attending high school or have a high school diploma/equivalent (such as a GED)?

Dates of Attendance

Additional High School Name (If attended)

Please select the option that best describes your total income for the year?

Are you or your family primarily dependent on Social Services/Public Assistance (TANF, SNAP, etc.)

Are you in foster care as established by the court?

Are you a veteran of the U.S. Armed Forces?

Are you currently serving on active duty in the S.S. Armed Forces for purposes other than training?

As of today, are you married? (Also answer yes if you are separated, but not divorced.)

Does someone other than your parent or stepparent have legal guardianship of you, as determined by a court in your state of legal residence?

Do you now have or will you have children who will receive more than half of their support from you?

Child Support Income (Yes/No)

Social Security Benefits (Yes/No)

Supplemental Security Income (SSI) (Yes/No)

Workers Compensation/Disability (Yes/No)

Unemployment (Yes/No)

Have you previously attended college?

Please wait for files to finish uploading