I understand the SSS Program will use the data provided on this form to assist in assessing any academic and/or career planning
needs and all information will be kept confidential according to FERPA laws. I hereby authorize the release of appropriate educational, financial aid, income, personal, disability documentation and other information as deemed necessary by the Director of Student Support Services for official professional use at Jefferson College.
I certify the information in the application is true and accurate to the best of my knowledge. If you agree, type "yes" here
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Student Support Services
- Project SUCCESS is 100% federally funded by the U.S. Department
For additional information
on Project SUCCESS, call Student Support Services at (636) 797-3000,
ext. 3281, or stop by the top floor of the Student Center, Room
It is the policy of Jefferson College that no person shall, on the basis of age, ancestry, color, creed, disability, gender, national origin, race, religion, or Veterans status
be subject to discrimination in employment or in admission to any educational program or activity of the college. If accommodations for a disability are needed, please
call Christine Platter at (636) 481-3169 or 797-3000, ext. 3169. Individuals with hearing/speech impairments may call TDD phone number (636) 789-5772 (Hillsboro).