The Transition to Independence Program
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Application Information
Name
*
First
Last
Date of Birth: XX/XX/XXXX
*
Student Access ID
*
Address
*
Line 1
Line 2
City
State
Zip Code
Country
What is the best phone number to reach you?
*
-
-
Back up phone number
*
-
-
Email that you check regularly
*
Important adult that can reached in case of emergency-include contact information
*
Do you have any siblings/relatives who are currently attending WSU
*
Yes
No
If yes, please provide their name and contact information
*
Please provide a brief response to the following items. This will assist us to determine the assistance you may require
What are your long term goals and what steps do you need to take to reach them?
*
What do you think the biggest challenge will be for you to attend college and why?
*
What do you believe you need to be successful at college?
*
How do you feel about asking for assistance and why?
*
Is there anything else you want to tell us about yourself?
*
Eligibility Statement
I was in foster care on or after my 14th birthday and if I was adopted out of foster care, the adoption occurred on or after my 16th birthday.
I agree to fully participate in the Transition to Independence Program. (TIP)
I understand that the TIP will contact the Department of Human Service agency or any other relevant agency to verify my eligibility to participate in the TIP. This includes obtaining Updated Services Plans and Child Assessment of Needs and Strengths and court orders.
I am aware that all information will be properly preserved and secure in only one location. The information will be used for contact related purposes only; no information will be shared with anyone outside of the program.
I understand that completion of this application does not guarantee admission to WSU or to the TIP.
By submitting this application I agree to all of the above. I agree that I will hold WSU harmless as a result of participation in the TIP. Applicants who are still in high school are strongly encouraged to apply for Tuition Incentive Program before graduation from high school by calling 888 4472687 and obtaining at least one court order from their case.
Case Worker Information
Address
*
Line 1
Line 2
City
State
Zip Code
Country
County in which the case is/was located
*
Phone Number
*
-
-
Email
*
Submit