Intake forms are evaluated periodically throughout the semester. Should you be selected for participation, you will be notified via KCC email. If you have questions, contact the Center for Student Success at 269.965.4150 or css@kellogg.edu.
First Name
k-ID or Date of Birth
Phone Number
City
State
Zip Code
Program of Study
U.S. Citizen:
Date of High School Graduation or GED
Last Name
Street Address
For additional assistance and potential funding:
2. Has either your mother or father received a four-year degree from a college or university?
1. Are you planning to transfer to a four year institution Immediately upon leaving KCC?
* The term "low-income individual" means an individual whose family's taxable income for the preceding year did not exceed 150 percent of the poverty level amount. see chart below
By clicking SUBMIT you state that:
The information provided is accurate to the best of my knowledge. I understand that I may be eligible for a
Center for Student Success program based on the information I provided.
* FEDERAL LOW-INCOME LEVELS
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