PERKINS V QUESTIONNAIRE

On July 31, 2018, the Strengthening Career and Technical Education for the 21st Century Act (also referred to as Perkins V) was signed into law. The Act includes provisions for helping special populations. This information is NOT used in the admissions process in any way. It is used only for delineated nondiscriminatory reporting to comply with Federal and State mandates.

Basic Contact Information:

First Name:

Middle Name:

Last Name:

Phone:

Email:

Address:

City:

State:

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Zip:

Student ID:

Will you be receiving veterans benefits for the upcoming semester? If yes, please contact the Coordinator of VA Services in the Financial Aid Office.

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Is English your primary (first) language?

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Do you receive Public Assistance?

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What is your financial aid status?
Did not apply
Applied
Applied and determined eligible
Applied. Determined Eligible and Awarded

I am....:
a homemaker. Worked in the home & needs retraining
a single parent
a single pregnant woman
not applicable

Have you previously participated or are currently participating in any Continuing Education program at Vernon College?

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What is your highest level of education attained?
Not a high school graduate
Texas Certificate of High School Equivalency
High School Graduate
Some College or Associate's Degree
Bachelor's Degree or Higher

Are you currently out of the workforce?

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Are you an individual with a primary nighttime residence that is a public or private place not designed for or ordinarily used as a regular sleeping accommodation for human beings, including a car, park, abandoned building, bus or train station, airport, or camping ground?

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Are you in, or have aged out of, the foster care system?

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Is your parent currently on military active duty?

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The Family Educational Rights and privacy Act of 1974 allows Vernon College to release "directory information" (name, address, major, dates of attendance, full-time or part-time status, degrees and awards received and dates granted, previous educational institution(s) attended, and eligibility and participation in officially recognized activities and sports) to interested parties. You may restrict release of directory information from all requestors not specifically authorized under the law. Do you give Vernon College permission to release directory information?

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Type the characters you see below: