University of Georgia College of Family and Consumer Sciences
STUDENT APPLICATIONFor the Spring (January) 2020 CohortDue: May 15th, 2019 ABOUT DESTINATION DAWGS: INCLUSIVE POSTSECONDARY EDUCATION at UGAWebsite: : Reflecting our tagline “Life is a journey. Be prepared for the trip”, our program’s goal is for Destination Dawgs graduates to have gained new knowledge, skills, and competencies which lead to a good adult life. This includes having a desired job, having an increased ability to live independently, and having friends and relationships that expand their social networks. DESIGN: The Destination Dawgs program design was informed by a number of national best practices to support students with intellectual and developmental disabilities to prepare for employment via inclusion in higher education. These include the 2011 Think College Standards, Quality Indicators, and Benchmarks for Inclusive Higher Education ( ); the Think College Building Inclusive Campus Communities: a Framework for Inclusion (2015; ); and the National Collaborative on Workforce and Disability’s (NCWD) 2016 Personal Competencies for College and Career Success: What Colleges Can Do ().TIMELINE: Five (15 week) semesters starting in the Spring (January) semester following the prerequisite Summer Leadership Institute for invited applicants. Semesters follow the UGA academic calendar. CREDENTIAL: Completion of the program will result in a non-degree UGA Certificate in College and Career Readiness from the UGA Center on Continuing Education bearing +/- 150 continuing education units. Student competency and accomplishments will be recorded in an electronic portfolio.STUDENT PLAN: The Destination Dawgs team will utilize the Students Transitioning to Adult Roles (STAR) Person-Centered Planning (PCP) model to facilitate goal setting and to track progress across five domain clusters: Career Development and Employment, Academic Enrichment, Campus & Community Engagement, Independent Living, and Self-Determination.PROGRAM COMPONENTS: Each semester students will engage in four program domains:Academic Courses Students will be enrolled in foundational courses offered through the Division of Academic Enhancement (UNIV courses) to increase the student's capacity for college success, in Directed Study courses (IHDD 3010) for individualized support, and in courses offered by UGA that align with the individual student's vision and career goals. Students will attend UGA courses with permission of department /instructor and satisfactory academic progress will be assessed each semester.Work-based Experiential Learning A minimum of three semesters of work-based experiential learning related to the student’s career goal is required. These experiences can be paid or unpaid and may include employment-focused learning opportunities both on and off campus. Time spent in work-based experiential learning settings will increase over the course of the third, fourth, and fifth semesters.Social and Extracurricular Activities Our goal is for the experiences of our students to be comparable to those of other undergraduates at UGA. All students will have a UGA student ID and access to auxiliary services. With the support of peer mentors, students will identify extracurricular activities he or she is interested in pursuing; determine how to balance social and academic life; and foster friendships.Independent Living Skill Building Students may participate in campus service activities, health and wellness seminars, workshops, and counseling. Students will also eat lunch each day with peer mentors, learn to navigate the UGA bus system, and may opt to live in on (if available) or off campus housing. APPLICATION FOR ADMISSIONApplications are currently being accepted by mail for the 2020 cohort. You will be notified via email when your entire packet has been received. Applicants will not be considered until the entire packet is submitted. If selected, the applicant will be invited to participate in a Summer Leadership Institute, and may be interviewed independently, as well as with his/her family or support person. Please note: due to limited space, not all applicants who complete the application process will be admitted to the Summer Leadership Institute, hosted by the J.W. Fanning Institute at UGA, to be interviewed for the Program. Admittance to the Summer Institute does not guarantee admittance to the Program. APPLICATION CHECKLIST?$60 application fee made out to the Institute on Human Development and Disability ?Student Application (pgs. 5 – 23)?Personal Statement from Student with a recent photograph/headshot of the student ?Student Questionnaire completed by applicant (pgs. 8 – 13)?Personal Support Questionnaire completed by parent (pgs. 14 – 19)?Parent Readiness Questionnaire (pgs. 20-22)?Official High School Transcript ?Behavioral records (if student has no record, send a letter from the high school stating there is no record)?Current or former IEP/504 plan which serves as evidence of the applicant’s eligibility for special education and related services under the IDEA?A documented comprehensive and individualized evaluation which includes:Psychological Evaluation, including IQ testing within the past three yearsAdaptive behavioral scores within the past three yearsSocial-emotional functioning within the past three yearsThis evaluation may be provided by the Regents Center for Learning Disorders at UGA.For more information and to schedule an evaluation go to: Recommendation forms (included) from non-family members who have known the applicant for at least one year. (pgs. 24 -33)?Copy of guardianship agreement, if applicable. Please note: The Destination Dawgs Program does not accept students who are under court ordered full /plenary guardianship.?Signed Memorandum of Understanding (pgs. 34-37)SUBMIT COMPLETED APPLICATION WITH RECORDS AND FEE TO: The Destination Dawgs ProgramInstitute on Human Development and Disability, the University of Georgia850 College Station Road, Rivers Crossing BuildingAthens, GA 30602-4806ATTN: Anna Lawrence, Program CoordinatorQuestions? E-mail: DestinationDawgs@uga.eduADMISSION CRITERIAApplicants must:Be between the ages of 18 and 25 in the year of admission. Older students will be considered if on-campus housing (when available) is not desired;Have a personal desire, and support from family, to gain skills for self-determination, independent living, and career development at the University of Georgia;Have an intellectual disability is a disability characterized by significant limitations both in intellectual functioning (reasoning, learning, problem solving) and in adaptive behavior, which covers a range of everyday social and practical skills. This disability originates before the age of 18.The applicant must have been (or is presently) eligible for special education and related services under the Individuals with Disabilities Education Act (IDEA);High school completion with diploma/modified diploma/certificate of completion; Not be under a full or plenary guardianship as ordered by a court of law. Limited or partial guardianship agreements will be considered and must be shared.Student must be able to be legally responsible for understanding and adhering to the UGA Code of Conduct: NO history of challenging behaviors;Have sufficient emotional and independent living skills necessary to participate in coursework and campus life; Be able to remain unsupervised for 12 hours;Be independent in handling his/her own medication, specialized dietary and/or medical needs, as well as in the use of his/her own medication. Staff is not available to manage/administer medications. The Destination Dawgs Program does not take responsibility for specialized diets or medical needs;Be able to sit through a class period (1.5 hours)Be able to read and write approximately at a 3rd grade levelHave transportation to and from campusConsent to being photographed and be able to consent to participate in research Have medical insuranceHave a cell phoneBe a United States CitizenParticipate in a Summer Leadership Institute overnight on campus (July 17-19) as a pre-requisite to admissionPROJECTED COST Spring/Fall 2020 (per semester)(Tuition and fees model the current UGA structure for applicable term and are subject to change) PROJECTED PER SEMESTER EXPENSESAcademic Tuition and student fees$4776 (in-state) for 6 or more course credit hours $1139 (required UGA student fees for auxiliary student services)Program Fee$3000 (administrative fees)Meal Plan (optional) 80 Block Plan plus 665 Paw Points/Semester$2,802/year/($1,401/semester)80 Block Plan plus 255 Paw Points/Semester$1,982/year/($991/semester)65 Block Plan plus 300 Paw Points/Semester$1,796/year/($898/semester)* These costs are from the 2018 – 2019 Academic Year. They are subject to change.** The tuition and fees cost does not include books, materials, or individual housing expenses*** Tuition and fees are the same as those for students registered for credit and are based on a 9-month academic year (spring/fall) for an average undergraduate student. Destination Dawgs Program is a non-degree Certificate Program. Transfer credits from other colleges or postsecondary programs are not accepted.Graduates will receive a UGA Certificate in College and Career Readiness and an electronic portfolio documenting competencies, skills, and accomplishments.STUDENT HOUSINGHousing for Destination Dawgs students is not currently available as a component of the program. Destination Dawgs program staff will not provide personal care and are available after academic program hours by arrangement only.Students who commute to campus and may secure a parking permit for a vehicle for an additional fee if desired. Apartments: For students who cannot commute but wish to live independently near campus, a number of off –campus student apartments are available. Monthly rent, distance from campus, and amenities vary. Destination Dawgs program staff can assist incoming students and families with identifying housing options and with support providing organizations if assistance with personal care and daily living are required. On-Campus Residence Halls: NOT CURRENTLY AVAILABLE. Students who desire to live in on-campus housing, if and when available, will complete a separate application and will be subject to UGA housing rates. Resources for procuring personal support services (which will be an additional expense) can be provided. Students will be assisted by volunteer peer mentors within program hours as available and appropriate. STUDENT INFORMATIONCONTACT INFORMATION | STUDENTAll communication will be via email.Student’s Full Name:Nickname (if applicable):Date of Birth (MM/DD/YY)Social Security #Cell Phone #( )Home Phone #( )Email Address(required)AddressCity, State, ZipHigh SchoolCity, StateStudent’s permanent residence is with: ? Mother ? Father ? Both ? Other: Does the student have a guardianship in place? ? No ? Yes, name of Guardian: CONTACT INFORMATION | PARENT(S)All communication will be via email.Mother’s Full Name:Father’s Full Name:Cell Phone #( )Cell Phone #( )Home Phone #( )Home Phone #( )Work Phone #( )Work Phone #( )AddressAddressCity, State, ZipCity, State, ZipEmail Address(required)Email Address(required)EMERGENCY CONTACT INFORMATIONName:Relationship:Cell Phone #Other Phone #AddressCity, State, ZipEDUCATIONAL HISTORYSchools Attended (Name, City, and State)Public orPrivate SchoolCalendar YearsAttendedReason for LeavingDid/will receive: ? High School Diploma ? Equivalent CertificateName of certificate received: Participated in general education classes: ? Yes ? NoIf yes, list inclusive classes taken:___________________________________________________________________________________________________________________________________________________________________________________________________________________If yes, describe accommodations used in general education classes. Were these used independently on a regular basis? (copies of notes, extended time, etc.)____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________To be completed by the student:What was the most challenging part of school (academically and socially)?___________________________________________________________________________________________________________________________________________________________________________________________________________________________2. What was the most enjoyable part of high school?___________________________________________________________________________________________________________________________________________________________________________________________________________________________3. What clubs or teams were you involved in? Awards won? Offices held?__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________4. What do you hope to learn or do in college that you did not do in high school?________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________5. What kind of job or career do you hope that college will prepare you for?________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________6. How did you hear about the Destination Dawgs Program? ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ STUDENT QUESTIONNAIRE(To be completed by student)Was a scribe used to complete this section of the application? Please circle: Yes or NoWhy do you want to attend the Destination Dawgs Program at the University of Georgia?____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________What are your plans for the future?____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________What kind of job would you like to have when you finish school? Why?____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________What do you like to do in your free time?____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Are you a social person or do you prefer to be alone?________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Describe a special relationship you have with a friend, mentor, or family member.____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Have you ever been away from your family for an extended period of time? If so, when and where?____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Do you prefer to commute to college or live on campus? How do you feel about that?____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Describe how you like to spend time when you are alone.____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Are you on Facebook, Instagram, Twitter or other social media? Do you check your accounts regularly? If not, would you like to be?____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________What else would you like us to know about you?____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________EMPLOYMENT HISTORYPlease complete the following including paid employment, unpaid employment, school-based employment training and internships. Attach a resume and references if applicable. Employment experience is NOT a requirement for admission. PAID EMPLOYMENTEmployer:Phone:Address:Supervisor:How did you obtain the job?Job Title:Responsibilities:From:To:Reason for Leaving:Employer:Phone:Address:Supervisor:How did you obtain the job?Job Title:Responsibilities:From:To:Reason for Leaving:Employer:Phone:Address:Supervisor:How did you obtain the job?Job Title:Responsibilities:From:To:Reason for Leaving:VOLUNTEER WORK/UNPAID INTERNSHIPSEmployer:Phone:Address:Supervisor:How did you obtain the position?Title:Responsibilities:From:To:Reason for Leaving:Employer:Phone:Address:Supervisor:How did you obtain the position?Job Title:Responsibilities:From:To:Reason for Leaving:Employer:Phone:Address:Supervisor:How did you obtain the position?Job Title:Responsibilities:From:To:Reason for Leaving: EMPLOYMENT REFERENCESFull Name:Relationship:Company:Phone:Address:Full Name:Relationship:Company:Phone:Address:Full Name:Relationship:Company:Phone:Address:What did you enjoy most about your work experiences? Why?____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________What types of internships or work experiences are you interested in for the future?____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________PERSONAL SUPPORT INVENTORY(To be completed by parent/guardian or support staff)Completed by: _______________________________________________Please fill in the information below as completely and honestly as possible. This information give a greater understanding of the student’s support needs and is not a determining factor in acceptance to the program. INDEPENDENT LIVING SKILLSFinds way around new environment??Has never had the opportunity?? Needs complete assistance?? Completely independentFollows a schedule independently?? Has never had the opportunity?? Needs complete assistance? Completely independentBathes daily?? Needs daily reminders?? With prompting/schedules?? Completely independentChanges clothes daily?? Needs daily reminders?? With prompting/schedules?? Completely independentBrushes teeth daily?? Needs daily reminders?? With prompting/schedules?? Completely independentAsks for help, clarification?? Needs prompting?? Always?? Only in familiar situationsUses good judgment in an emergency? Has received instruction, but has not been in the situation?? Has not received instruction? Completely independentCopes well with stress?? Needs assistance?? Has and uses coping strategies?? IndependentAdjusts well to new environments?? Needs much assistance?? Needs little assistance?? IndependentPrefers to do things for himself/herself?? Yes?? No?? Frequently requests assistanceLaundry?? Sorts?? Operates washer?? Operates dryer?? Folds?? Irons?? Does not do laundryINDEPENDENT LIVING SKILLS (CONT.)Cooks? No? Completely independent? Very basic (Give example: _)Has attended camp away from home? Yes (For how long? _______________) ? NoSets appointments for himself/herself? Yes? NoHas travelled? Yes, flown alone? Yes, flown with adult? Internationally? Yes, bus alone? Yes, bus with adult? No? Other: Has driver’s license? Yes, drives on own? Yes, drives with parent/adult only? Learner’s Permit only? Student does not driveWhat chores is the student responsible for at home?Is the student able to manage his/her own time?? Arrives on time? Allows enough time to walk to classes, etc.? Uses alarm clock? Uses schedule or day planner? NoIs student independently able to use:? Laptop? Debit card? Flash drive? Cell phone? ATM? Attach a document to an email? Email? PrinterCuts fingernails and toenails? Needs complete assistance? Needs daily reminders? With prompting/schedules? Completely independentShaves face/legs? Needs complete assistance? Needs daily reminders? With prompting/schedules? Completely independent SOCIAL SKILLS AND COMMUNICATION Communicates needs appropriately ? Yes? No? With promptingEngages in age appropriate interaction? Yes, socializes with same age peers? Does not socialize? Socializes mostly with family? Socializes with older? Socializes with youngerDeals with conflict? Needs much assistance? Seeks assistance? Needs limited assistance? IndependentDistinguishes between friends & strangers? Yes? No? Has not been in the situationFollows rules? Yes, is a rule follower? Needs reminders? Struggles following rulesOrders and purchases from a restaurant/store? Yes? No? Needs assistanceRespects authority figures? Yes? No? Depends on the relationshipUses cell phone? Phone calls? Text messages? Calendar/day planner? Alarms? Apps? Internet browsingIs able to provide personal information? Address? Emergency contact? Medication information? Insurance information? Phone number? Email addressUses email? Has email account but does not use? With assistance? Independently? Remembers passwords? Needs reminder for passwordsMaintains appropriate social behavior? With prompts? Independently with family? Needs reminders in public situations? Independent in public situationsHow does the student manage anger/anxiety?Dating experience? Has not dated? Has dated? Online dating? No experience, but is interested in datingIs the student currently involved in activities that are specially created for individuals with disabilities?? No? Yes? Yes, inclusive activitiesACADEMIC SKILLSReading skills? No functional reading? Reads chapter books? Reads books silently? Can answer questions about a reading selection? Can summarize a reading selection? Reads books for pleasure? Makes inferences? Approximate grade level reading ability: ? Title of last book read:Math skills? Handles money to make a purchase? Counts change in bills? Manages a checking account? Stays within a budgetComputer skills? Word processor? Internet search? Remembers password? PowerPoint? Requires assistance? Uses Mac? Uses PC? Does not use the computerFollowing verbal directions? Yes? No? With reminderFollowing written directions? Yes? No? With reminderTime Management? Uses a calendar? Makes appointments? Needs complete assistance? Keeps planner/agenda? Sets reminders on phone? On timeStudy Habits? Studies independently? Has tutor? Requires one on one assistance? Requires prompting? Does not have homeworkNote-taking? Takes own notes? Uses technology? Requires copies of notesWriting skills? Has written papers? Writes simples sentences? Drafts, revises and edits? Writes short paragraphs? Uses punctuation? Takes notes during class? Copies notes from board? Does not write? Uses technology for writingListening skills?Can retell a story? Able to retell settings, problems, events and solutions?Creates questions based on information presentedTutor/assistant? Attended class with student? Assisted with work one on one? At home tutor? No tutor or assistantAssistive technology? iPad- apps: ? Live Scribe Pen? Laptop? Voice Recognition software? Dragon Naturally Speaking? OneNote? Evernote? Recording device? Google apps? Other: Please feel free to provide any supporting documentation.Please provide any additional information for consideration regarding the applicant. Include any relevant social, emotional or educational factors. We are looking for a true picture of the student’s overall level in academics, social skills, independent functioning and employment readiness.____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________What goals does the family/parent have for the student while in college?________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________PARENT READINESS SURVEY(To be completed by parent / guardian or primary support person)APPLICANT NFORMATIONStudent Name:Parent/Guardian Name: STUDENT SAFETYI expect one-on-one support for my student all day.? Strongly Agree? Agree? Neutral? Disagree? Strongly DisagreeI worry about my student talking to other students unsupervised.? Strongly Agree? Agree? Neutral? Disagree? Strongly DisagreeI worry about my student crossing the street.? Strongly Agree? Agree? Neutral? Disagree? Strongly DisagreeI check to see if my student has the correct facts.? Strongly Agree? Agree? Neutral? Disagree? Strongly DisagreePOSTSECONDARY PROGRAMSI expect to know everything my student does at the university.? Strongly Agree? Agree? Neutral? Disagree?Strongly DisagreeI need to know the homework assignments for each class my student takes.? Strongly Agree? Agree? Neutral? Disagree? Strongly DisagreePOSTSECONDARY PROGRAMS (CONT.)I need to know the calendar of social activities offered to my student.? Strongly Agree? Agree? Neutral? Disagree? Strongly DisagreeI know my student, with support, will develop friendships.? Strongly Agree? Agree? Neutral? Disagree? Strongly DisagreeI know my student, with support, will try new opportunities.? Strongly Agree? Agree? Neutral? Disagree? Strongly DisagreeDIRECT INVOLVEMENTI would like to attend classes to see my student interact with others.? Strongly Agree? Agree? Neutral? Disagree? Strongly DisagreeOften, I am in contact with my student more than three times a day.? Strongly Agree? Agree? Neutral? Disagree? Strongly DisagreeI would like to speak with my student’s mentors.? Strongly Agree? Agree? Neutral? Disagree?Strongly DisagreeI check up on my student in person if I can.? Strongly Agree? Agree? Neutral? Disagree? Strongly DisagreeSTUDENT’S STRENGTHS AND CHALLENGESMy student has the ability to handle frustration appropriately.? Strongly Agree? Agree? Neutral? Disagree? Strongly DisagreeI trust my student’s judgment.? Strongly Agree? Agree? Neutral? Disagree? Strongly DisagreeSTUDENT’S STRENGTHS AND CHALLENGES (CONT.)My student has the ability to seek assistance.? Strongly Agree? Agree? Neutral? Disagree? Strongly DisagreeI trust my student’s ability to handle small sums of money. ? Strongly Agree? Agree? Neutral? Disagree? Strongly DisagreeI feel that my student knows what is best for him/herself.? Strongly Agree? Agree? Neutral? Disagree? Strongly DisagreeCONCERNS ABOUT THE FUTUREI believe a postsecondary education is important for my student.? Strongly Agree? Agree? Neutral? Disagree? Strongly DisagreeI feel that my student wants to attend the university.? Strongly Agree? Agree? Neutral? Disagree? Strongly DisagreeMy student will live independent of our family after graduation.? Strongly Agree? Agree? Neutral? Disagree? Strongly DisagreeMy student will have meaningful employment after graduation.? Strongly Agree? Agree? Neutral? Disagree? Strongly DisagreeMy student will no longer have a disability after graduation.? Strongly Agree? Agree? Neutral? Disagree? Strongly DisagreeMy student will lead the Student Centered Planning in order to achieve his/her goals.? Strongly Agree? Agree? Neutral? Disagree?Strongly DisagreeRECOMMENDATIONS AND RELEASE(To be completed by non-family members)Please list the following information for recommendations. Individuals sending recommendations should know the student well and be able to speak to his/her readiness for college: RECOMMENDATION 1 Name:Position:Address, City, State:Phone:Email: RECOMMENDATION 2Name:Position:Address, City, State:Phone:Email: RECOMMENDATION RELEASEI agree to waive my right to access the student recommendation forms.Applicant NameApplicant SignatureDateParent NameParent SignatureDateRECOMMENDATION FORM (1)For:_______________________________(Applicant Name)The above named individual has applied for admission to the Destination Dawgs program at the University of Georgia. The Destination Dawgs program provides young adults with intellectual disabilities an inclusive college experience that will further their academic, employment, social, and independent living skills. Please answer the following questions to the best of your ability. Applications will not be reviewed without recommendations. Applicants have waived their right to access the recommendation form. Your timely completion of this form is greatly appreciated by the applicant. If you have further questions please contact the Destination Dawgs program at DestinationDawgs@uga.edu. Thank you. CONTACT INFORMATIONYour Name:Title/Organization:Address:City:State:Zip:Phone:Email Address:How long have you known the applicant?________________________________________________________________________________________________________________________________________________________In what capacity?________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Are you familiar with the Destination Dawgs Program? Please circle: Yes / NoDo you feel the applicant would benefit from this postsecondary education program in the area of ACADEMICS? Why or why not?________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Do you feel the applicant would benefit from this postsecondary education program in the area of SOCIAL SKILL BUILDING ? Why or why not?____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Do you feel the applicant would benefit from this postsecondary education program in the area of INDEPENDENT LIVING? Why or why not?____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Do you feel the applicant would benefit from this postsecondary education program in the area of CAREER DEVELOPMENT? Why or why not?____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Does the applicant have any behaviors that would interfere with their ability to participate in the Destination Dawgs program? Please circle: Yes / No. Please comment on any behavior supports the applicant may need:________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Please discuss the student’s level of independence. Please comment on any supports that applicant may need: ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Please discuss the student’s social skills. Please comment on any supports the applicant may need: ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Discuss how the student manages stress. Please comment on any supports the applicant may need:________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Please describe the applicant in detail. Include any additional information or commentary about the applicant. If you need more space, please attach an additional page. We are looking for a true picture of the student’s likely success overall in academics, living independently, increasing social connections, and employment readiness. ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Thank you!Please return the completed recommendation form to:The Destination Dawgs ProgramInstitute on Human Development and Disability, the University of Georgia850 College Station Road, Rivers Crossing BuildingAthens, GA 30602-4806ATTN: Anna Lawrence, Program Coordinator RECOMMENDATION FORM (2)For:_______________________________(Applicant Name)The above named individual has applied for admission to the Destination Dawgs program at the University of Georgia. The Destination Dawgs program provides young adults with intellectual disabilities an inclusive college experience that will further their academic, employment, social, and independent living skills. Please answer the following questions to the best of your ability. Applications will not be reviewed without recommendations. Applicants have waived their right to access the recommendation form. Your timely completion of this form is greatly appreciated by the applicant. If you have further questions please contact the Destination Dawgs program at DestinationDawgs@uga.edu. Thank you. CONTACT INFORMATIONYour Name:Title/Organization:Address:City:State:Zip:Phone:Email Address:How long have you known the applicant?________________________________________________________________________________________________________________________________________________________In what capacity?________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Are you familiar with the Destination Dawgs Program? Please circle: Yes / NoDo you feel the applicant would benefit from this postsecondary education program in the area of ACADEMICS? Why or why not?________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Do you feel the applicant would benefit from this postsecondary education program in the area of SOCIAL SKILL BUILDING ? Why or why not?____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Do you feel the applicant would benefit from this postsecondary education program in the area of INDEPENDENT LIVING? Why or why not?____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Do you feel the applicant would benefit from this postsecondary education program in the area of CAREER DEVELOPMENT? Why or why not?____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Does the applicant have any behaviors that would interfere with their ability to participate in the Destination Dawgs program? Please circle: Yes / No. Please comment on any behavior supports the applicant may need:________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Please discuss the student’s level of independence. Please comment on any supports that applicant may need: ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Please discuss the student’s social skills. Please comment on any supports the applicant may need: ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Discuss how the student manages stress. Please comment on any supports the applicant may need:________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Please describe the applicant in detail. Include any additional information or commentary about the applicant. If you need more space, please attach an additional page. We are looking for a true picture of the student’s likely success overall in academics, living independently, increasing social connections, and employment readiness. ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Thank you!Please return the completed recommendation form to:The Destination Dawgs ProgramInstitute on Human Development and Disability, the University of Georgia850 College Station Road, Rivers Crossing BuildingAthens, GA 30602-4806ATTN: Anna Lawrence, Program Coordinator MEMORANDUM OF UNDERSTANDING BETWEEN THE UNIVERSITY OF GEORGIA (UGA) DESTINATION DAWGS PROGRAMANDTHE PARENT OF THE STUDENTUniversity of Georgia’s Destination Dawgs program serves students with Intellectual and Developmental Disability (I/DD) on the UGA campus. During this two and a half year transition experience, eachDestination Dawgs student is expected to participate in UGA classes, participate in campus activities, and gain employment experience.The purpose of the Destination Dawgs program is to facilitate transition by Destination Dawgs students into the adult community. This means that Destination Dawgs graduates are prepared to live and work as independently as possible. Specifically, the Destination Dawgs team has anexpectation that after the Destination Dawgs program, the Destination Dawgs graduate will live in his or her own house or apartment with necessary support and will work in a community-based, career choice job with necessary supports (i.e., not in a sheltered workshop or in a day activity center). Only individuals with I/DD, who, along with their parents, agree with this expectation, should pursue the Destination Dawgs program as a transition option.This Memo of Understanding (MOU) is established to better assure success in the Destination Dawgs program and to promote greater independence in the student’s post-Destination Dawgs community. The agreement is intended to clearly convey that the Destination Dawgs program requires a partnership between parents and the Destination Dawgs staff, and that both must make a commitment and take specific actions to achieve the desired outcomes of the Destination Dawgs program.Continuation in the Destination Dawgs program by Destination Dawgs students requires that parents also fulfill their responsibilities as specified in this document to achieve these outcomes, just as the Destination Dawgs staff will focus on preparing is graduates to achieve the desired outcomes.To enter and participate in the Destination Dawgs program, parents agree to the following:All of the information provided in this application is accurate to the best of his/her knowledge.Guardianship: Verify that the student is his/her own guardian (parent or other does not have full/ plenary guardianship over the student).Behavior: Verify that the student has no current behavior problems. Please indicate the following:Student has had a Functional Behavioral Analysis (FBA) completed? NO? YES, if so, when and for what? _________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Student has had a Behavior Intervention Plan (BIP)? NO? YES, if so, when and for what? _________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Student has ever received home bound instruction for any reason (medical, behavioral, other)? NO? YES, if so, when and for what? _________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Payment: Pay in full each semester by the date set by the Destination Dawgs team including a non-refundable Destination Dawgs program fee, university tuition, and UGA student fees. Failure to pay in full by the deadline may result in cancellation of the student’s program in adherence with UGA policy.Orientation: Participate in a Parent Orientation upon student acceptance to receive and discuss the Destination Dawgs Parent Handbook for policies and procedures relevant to the program.Scheduling: Check student’s schedule each week to know what time drop off and pick up is. Parents and/or students will provide a minimum of 24 hours notice to Destination Dawgs staff if the student will not be on campus at the scheduled time. Extra fees will apply if schedules are not followed or time on campus is longer than planned.Academics: Instructors (UGA and Destination Dawgs alike) have the right to add/remove assignments and assessments listed in the syllabus to accommodate the individual needs of students. Materials: Provide materials necessary for successful college participation in a timely manner (within one week when requested by Destination Dawgs staff or instructors) including but not limited to paper, pens, pencils, flash drive, printer, computer, cell phone, binders, book bag).Communication: Communicate directly with Destination Dawgs staff and faculty if questions or concerns arise. Parents will not directly contact UGA instructors or Destination Dawgs peer mentors.Time on Campus: Parents will not attend courses, loiter on campus, or otherwise violate UGA’s policies related to guest verification and identification. Privacy: Acknowledge that peer mentors and staff are not required to provide them, or their student, with their personal contact information (cell phone number or personal email address). The decision to share contact information will be made solely by the mentor/staff as he or she wishes. Code of Conduct: Destination Dawgs students must adhere to UGA’s Code of Conduct. If behavioral issues occur, students will adhere to disciplinary processes determined by UGA. This may include that parents agree to collaborate with the Destination Dawgs staff to develop a Behavior Intervention Plan (BIP) designed to improve their son or daughter’s behavior. If after implementation of the BIP serious infractions of the Code of Conduct continue to occur, parents or guardians agree to pick Destination Dawgs their son or daughter and remove him or her from the UGA campus on the same day they are contacted when requested by Destination Dawgs staff. If violations of the Code of Conduct continue, parents understand that the Destination Dawgs staff may elect to dismiss their son or daughter from program and agree to comply with this decision by removing their son or daughter and his or her personal belongings from the UGA campus within 24 hours after notification.Transportation: It is the responsibility of the family to coordinate transportation to and from campus. Participation: Barring emergencies, families will participate in their student’s person-centered plan each semester and will follow through on tasks which will support successful transition into the community in which the student will live. These may include:Contacting the local GVRA field office to ensure VR support is secured if qualifiedIdentification of employment opportunities that align with the students interest and preparationCreation of a micro-board for the student to allow persons of the student’s choosing to assist him/her with ongoing planning and support post-graduationListening to the student about where he/she would like to live Making a transition plan that reflects the students’ desires and skill as expressed during the Destination Dawgs program.It is understood that acceptance and continuation in the Destination Dawgs program will be determined each semester based on the student progress; appropriately following UGA’s Code of Conduct; and adherence to program requirements as specified above.Parents understand that without adequate progress in any of the programmatic areas, including adherence to requirements by parents, the Destination Dawgs staff may elect to dismiss their son or daughter from the Destination Dawgs program and they will comply with this decision by removing their son or daughter and his or her personal belongings from the UGA campus.The UGA Destination Dawgs Staff agrees to the following:Provide an initial orientation period (Summer Institute experience) for the potential students to allow for campus familiarity and a sample of on-campus college experiences before full admission;Collaborate with university faculty and staff to provide students with access to college courses attended by enrolled students without disabilities;Provide academic advising that includes courses related to career and personal interests;Allow students to participate in courses that align with their career goals and assist with coursework;Prepare students for competitive employment by facilitating meaningful on-campus unpaid internships or paid part-time jobs each semester;Provide additional organized activities for students (e.g., health/wellness seminars, extracurricular events, career fairs, etc).Schedule Destination Dawgs students in UGA courses, work-based experiential learning, extracurricular activities, and opportunities to build independent living skills. Monitor progress throughout the college experience including Satisfactory Academic Progress, competencies in social and extracurricular activities, and work-based experiential learning. Collaborate and assist with families, university faculty and staff, university students, and community service providers to provide full access to campus life;Provide resources and community mapping options to students and families;Provide a University of Georgia Center on Continuing Education Certificate in College and Career Readiness to students who complete the program requirements and successfully meet the benchmarks for success.By your signature below, you indicate that you understand and agree to the provisions in this MOU:Parent’s Signature: ______________________________________________ Date: ____________Parent’s Name (Please print): _______________________________________________________Destination Dawgs Student Applicant (Please print): _______________________________________Destination Dawgs Director’s Signature: _____________________________________Date:_______(signed upon student acceptance to participate in the Destination Dawgs program) ................
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