Walters State Forms
Application for COTE 2023-2024 Success and Innovation Grant
Application for the Success and Innovation Grant for 2023-2024
Please read and fill out all information on this application.
First Name:
(required)
Last Name:
(required)
What is your complete address?
(required)
What is your Senators Mail Email Address/
(required)
What is your WS W#?
(required)
What is your cell phone number?
(required)
What is the name of the high school you graduated from? Year of graduation? Location of High School?
(required)
Which qualifications do you meet? (see information sheet)
(required)
First Generation
Member of an underrepresented population (Racial Minority)
Non-traditional student (age 25 years or older)
Living in Hawkins, Claiborne, or Union Counties
Veteran
Documented Disability
Please expain why you are applying for this grant and include any special circumstances of financial need you may have.
(required)
Have you been accepted to WSCC?
(required)
YES
NO
Have you completed the FAFSA?
(required)
YES
NO
How to pull up, save and attach your Student Aid Report (SAR):
How to pull up, save and attach your Student Aid Report (SAR): 1) Go to FAFA website: https://studentaid.gov/h/apply-for-aid/fafsa 2) Login 3) After logging in, about halfway down the page it will say, "View or Print your Student Aid Report or SAR" 4) Click the link 5) Save the document 6) Attach it to this application
Upload a copy of your Student Aid Report
What is your Major?
(required)
What is your parents' highest level of School? ( Highest for both parents collectively)?
(required)
Elementary
High School
Vocational School
College
What is your county of residence?
(required)
Claiborne
Cocke
Grainger
Greene
Hamblen
Hancock
Hawkins
Jefferson
Sevier
Union
Other
What is your Ethnicity?
(required)
Black of African American
White
Asian
American Indian
Alaskan Native
Native Hawaiian or Other Pacific Islander
Do you consider yourself to be Hispanic,Latino,or of Spanish Origin?
(required)
YES
NO
Do you understand if you receive this grant, you will be required to attend THREE cultural events each semester and join a club or organization?
(required)
YES
NO
Do you understand that if you are under 21 years of age, by accepting this grant, you give this office permission to contact your parent/guardian regarding your academic progress and /lack thereof, as well as social issues?
(required)
YES
NO
Do you understand that if given this grant, you will need to meet/contact the appropriate staff from this office at least twice a semester?
(required)
YES
NO
By typing your name below, you acknowledge that all information you have submitted in this form is correct and this will be used as an electronic signature.
(required)