*If you do not have a middle name, please enter - in the MI box
The Federal Government refers to Hispanic origins as Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin.
*General Studies and Pre-nursing students are not eligible to apply for TOP. Students must be enrolled in an Oregon Tech Bachelor’s degree program for eligibility
All information I have submitted on this form is true and complete. I understand this information is confidential and will
be used for statistical purposes. Further, in order to verify my eligibility and in the event that I am accepted to the Tech
Opportunities Program (TOP), I release the following information to TOP: