Application to Participate
NKU Supported Higher Education Project: SHEP Application
* To be considered for the SHEP program, you must submit two letters of recommendation.
Today’s Date: ______________
Student Participant Contact Information:
Name: _________________________________________________________________
Address: _______________________________________________________________ _________________________________________________________________
Student’s Cell Phone Number: ______________________________________________
Student’s Email Address: __________________________________________________
Student’s Date of Birth: ____________________________________________________
Parent/Guardian Contact Information:
Parent/Guardian Name: ____________________________________________________
Parent/Guardian Phone Number: _____________________________________________
Parent/Guardian Email Address: _____________________________________________
Tell Us About Yourself:
1. If you are currently a high school student, please write the name of your high school:
__________________________________________________________________
When will you finish high school? ___________ (month, year)
What year do you plan to begin college? ___________ (month, year)
2. Did you exit high school (or do you plan to do so) with:
_____Diploma
_____ Alternate Diploma
_____Certificate of Attainment
3. If you are currently NOT a high school student, what do you do during the day?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
4. Do you receive services from any of the following:
____OVR (Voc Rehab) ____ SCL
____Michelle P. Waiver ____Consumer Directed Option (CDO)
____Hart-Supported Living ____Home/Community Based (HCB)
____Other_____________________________________________________
6) The purpose of SHEP is to help students continue their education beyond high school. Please tell us why you would like to continue your education beyond high school and go to college:
____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
7) What do you see yourself studying? What kinds of classes do you think you would expect to take?
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
8) Who will be supporting you as you pursue a college education? (Mark all that apply.)
____Parents/Guardians ____Siblings
____Neighbor ____Other Relatives
____ Friends
____Other (Explain) _____________________________________________
9) Where do you expect to live while you go to college?
___At home, with parents
___In a college dormitory
___Other (please explain) ___________________________________________
10) If you were to attend college, how would you get there?
____Drive my self
____Parents and family members
____ Friends
____Carpool
____City Bus
____Uber or Taxi
____Don’t know
____Other (Please explain)__________________________________________
11) What do you think will be the easiest part of going to college? ________________________________________________________________________________________________________________________________________________________________________________________________________________________
12) What do you think will be the hardest part of going to college?
________________________________________________________________________________________________________________________________________________________________________________________________________________________
13) What kinds of supports do you think you need to go to college? What seems to help you best? ______________________________________________________________________
______________________________________________________________________
14) How did you hear about the SHEP program? ____________________________________________________________________________________________________________________________________________________________________________________
We look forward to talking with you.
Please return this application, along with two letters of reference to:
Emily Hellmann, SHEP Program Coordinator
Northern Kentucky University
College of Education
MEP 100, Nunn Drive
Highland Heights, Kentucky 41099
You can reach Emily at hellmane2@nku.edu or 859-572-6149
[pic]
................
................
In order to avoid copyright disputes, this page is only a partial summary.
To fulfill the demand for quickly locating and searching documents.
It is intelligent file search solution for home and business.
Related download
- cmo needs assesment survey example 1 19 2021
- performance work statement template
- home mountain line fixed route service in flagstaff
- application to participate
- of the proceeding
- professional development for teachers of the visually impaired
- driver agreement template
- meeting minutes for 07 11 2007 meeting between
- transport options from canberra airport to anu halls of
Related searches
- application to transfer cna license
- how to add a application to desktop
- free application to edit pdf
- application to application integration
- 501c3 application to fill out
- how to add application to desktop
- how to add application to automatic startup
- application to renew driver s license
- application to transfer cna
- dmv application to renew license
- college application to do list
- get paid to participate in research studies