TOP Application

About You

*If you do not have a middle name, please enter - in the MI box

Local Address

Permanent Address

Contact Information

Other Information

Ethnic Origin*  

The Federal Government refers to Hispanic origins as Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin.

Are you:

Race:(please check all that apply)

Eligibility Information*  

( at least one of the following must be selected to qualify )

Academic Information

*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


Verification and Release of Information

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:

  • Disability Documentation
  • Mid-term and Final Grades Information
  • Placement scores
  • Transcripts: Admissions and Registration
  • Standardized Test Scores (ACT/SAT/GED)
  • TRiO records of other schools
  • Income Information (Federal 1040 or other appropriate income documentation)
  • Financial Aid Information initial here to rely solely on FAFSA data*

*My family did not file federal income taxes last year: My family's adjusted gross income was: $


  1. I agree to complete an exit interview in the event of withdrawal, transferring, or graduation from Oregon Tech.
  2. I understand that TOP administrators will contact my instructors on an as-needed basis.
  3. If living in the residence hall, I understand that TOP can release that I am a TOP participant to the residence hall’s professional staff.