Thank you for your interest in our Student Support Services (SSS) Program at UMASS Boston! The program starts your first week on campus. You will work closely with your SSS advisor to explore majors, careers, mentoring and to access and receive subject area tutoring. We also want to help you create a plan to work toward your future career or graduate school. Please complete this application as thoroughly as possible. Please only submit ONE application. You cannot save and restart this application. 

You may want to review the required items, take some time to make notes, and gather the required documents.

  • You must upload yours or your parents' most recent 1040 tax form that shows the taxable income (first two pages only) or your Student Aid Report (SAR) that you can download from your FAFSA account.  
  • If you have a disability, please include your IEP, 504 plan, or proof registration with the Ross Center at UMass Boston.

If you have any questions, please call our office at 617-287-5820.
General Information
First Name *
Middle Name
Last Name *
Date of Birth *
Gender
Were you a Boston Public School Graduate? *
School ID *
Ethnicity *
Race, Black or African American *
Race, Asian *
Race, American Indian or Alaskan Native *
Race, Hawaiian or other Native to Pacific Island *
Race, White *
Permanent Address *
Permanent City: *
Permanent State: *
Permanent Zip: *
Permanent Phone: *
Email Address *
Citizenship:
Are you a US Citizen?
If not, are you a U.S. Resident?
If you are a Resident, provide you Green Card Number (Alien registration # that starts with "A"
Academic Information:
Eligibility *
Current Grade Level *
How many classes are you taking?
Current GPA:
If you had an IEP/504 plan in high school or through a government agency, you could register with the Ross Center for Accommodations. *
How's your academic standing?
Family Information:
Parents 1 Educational Level: *
Parent 2 Educational Level: *
Family Income Range: *
Student Aid Report (SAR) Documents
1040 Tax Document (First Two Pages)
SUPPLEMENTAL INFORMATION DETERMINATION OF PARTICIPANT’S NEED FOR ACADEMIC SUPPORT   
Are/were you a DSP participant? Please type DSP/Year if yes *
Do you have an ALEKS math placement Score? Please type your ALEKS score if yes *
Were you participant in another TRIO program? (Please indicate the location of the program) (5.)
Program Location:
Current and Past Taken Courses *
If you were referred to SSS by an advisor, counselor, or staff member, please indicate the reason. *
Answer Here:
Are you a Full-Time Student or Part time Student? *
How many courses will you be taking this semester? *
Your Current Major is: *
Please select the drop-down option that applies to you *
If you are a transfer student, where did you transfer from?
While in school, how many hours per week do you work? *
Do you have ample familial support at home in your pursuit of a college degree? *
Within the past 12 months, my family and I worried whether our food would run out. *
Within the past 12 months, I and/or my family worried whether we would be able to pay for rent. *
Would you like your advisor to know more about your family situation? (Optional)
Has your physical or mental health impacted your ability to do well in your studies? *
Which areas do you feel you need additional support to be successful? *
Difficulties you may encounter taking courses remotely: *
Other concerns/issues (please list)

Read Policies on Responsible/Acceptable Use of Computing and Data Resources found in this link before signing this form and return it to your advisor.

https://www.umb.edu/it/about/policies/acceptable_use.

I have read and received a copy of the University Of Massachusetts Boston Responsible/Acceptable Use Of Computing and Data Resources outline and agree to the terms of usage in the document.
Signature
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Applicant Signature
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Terms of Submission:
By submitting this application, you acknowledge that all of the above information is correct and accurate to the best of your understanding.