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


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




How confident are you in your skills in the following areas

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*


  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 Campus Housing, I understand that TOP can release that I am a TOP participant to the Campus Housing’s professional staff.