EOC Logo

Thank you for your interest in our Talent Search program!  Please complete this application as thoroughly as possible.  You cannot save and restart this application. 

 If you have any questions, please call our office at (570) 331-6755 or email carolyn@eocinc.org


Student Information:
Last Name *
First Name *
Middle Name
Date of Birth *
Current Age *
Race/Ethnicity *
Address *
Address
City *
State
Zip *
Cell Phone *
Email (prefer non-school) *
Citizenship Status *
Gender *
I have been in Foster Care or Guardianship
Describe your primary reason for applying to the Talent Search Program:

Academic Information:
Current Grade Level *
Current School *
I need the most help with: *
Dual Enrollment *
HS Seniors-Potential College Choice:
Career Notes


Parent Permission:
Parent/Guardian Name *
Parent/Guardian Cell Phone *
Parent/Guardian Email
Parent Preferred Contact Method
Parent 1 Highest Education Level *
Parent 2 Highest Education Level *
How many people in your household? *
Household Income Range *
Household Taxable Income is:
Is anyone in the house receiving:
Tax/Financial Documents-Optional
Do you have additional children in grades 6-12 to register?
Parent/Guardian Signature *
Please select a signature verification type.

Access to Quality Tutoring: In order to maintain good grades or improve your grades in specific subjects, Educational Talent Search Program can connect you with quality tutoring opportunities. Should you wish to take advantage of these Free tutoring opportunities-please contact your Talent Search staff or https://eocinc.org/tutoring-program

My signature acknowledges that I am aware that I have access to quality tutoring.

Sign and Submit:

Applicant Signature *
Please select a signature verification type.