RESOURCE CENTER ASSISTANCE APPLICATION
|
|
- Reynold Rich
- 5 years ago
- Views:
Transcription
1 RESOURCE CENTER ASSISTANCE APPLICATION Please clearly print all information on application. Complete the application in blue/black ink. Do not leave any blank spaces enter 0 or N/A if it does not apply. Make sure all required documents are returned with your application. Incomplete applications cannot be processed and will be returned. Section One: Please fill out this section completely. The SID is your CBC Student ID number. Print and attach your class schedule. Checkmark the box(es) next to the assistance you are requesting. If you are requesting childcare assistance, fill out the box on page four. Travel students need to fill out their physical address, and submit a form of correspondence showing student s name at same address. Mail submitted to verify address can be no older than one month. Section Two: Completely fill out the Income Chart. Write the income amount or a 0 in each box. o The first column is for your income information. o Fill out the second column and list the income and amount for the other people in your home. Write in the number of people who live in your household, and/or any persons living outside the home who contribute income to the household. List their names and relationship to you. Section Three: Print out your financial aid information using the Financial Aid Portal in the CBC Kiosk. See instructions in section three of this application. Check box indicating financial aid status. Section Four: Read the statement, sign, date, and print your name at the bottom of the page. 1
2 Frequently Asked Questions Q: I live with family/roommates/friends, but I pay all of my own bills/split expenses. Do I still need to bring in their income information? A: In order to verify your income status, you will need to have the people who you are living with write and sign a short note stating how bills are being shared and the expense amounts. Q: My mailing address is a P.O. box, so I don t have any letters with my name and home address. What can I turn in to verify my physical address? A: Alternate verification that we ll accept includes a copy of your lease with your name and home address, utilities billing statement, or other form showing your name and home address. A Driver s License will NOT be accepted as proof of address. Q: I m having trouble finding a licensed childcare provider. Where can I go for help? Do I have to wait until I have licensed care to turn in my application? A: You may turn in your application before you have a licensed childcare provider; however, if approved for the program, we cannot provide assistance until you have started using licensed care. If you are having trouble finding a provider, Child Care Aware of Washington (wa.childcareaware.org/families) has an online search tool, or you can call them at If you have a provider in mind and you want to check their license status, you can use the Child Care Check tool on the website for the Washington State Department of Early Learning (del.wa.gov). You can also call the community help line, 211, for assistance. The Resource Center does not provide referrals. Q: Once I turn in my application, how long will it take to process? A: Applications are typically reviewed within one week. If more information is necessary for your application, this can delay the process. Q: How will I be notified if I am accepted/denied, or if more information is needed? A: We will send an acceptance/denial letter to the address you have listed on the application. We will call the contact phone number listed on the application if more information is needed. 2
3 THE RESOURCE CENTER Assistance Application Columbia Basin College 2600 N. 20 th Avenue MS-T7 Pasco, WA Phone: Fax: Date Stamp Here Please clearly print all information on the application in blue or black ink. Submitted applications are processed on a first-come/first-served basis. Incomplete applications will be returned. Section 1: Name (please print) SID Mailing Address City State Zip Physical Address City State Zip Home Phone ( ) Cell Phone ( ) Date of Birth Emergency Contact Person Phone ( ) Current class schedule is attached REQUESTED ASSISTANCE: Childcare Reimbursement Travel Expense Assistance Distance must be at least 50 miles round trip from CBC. GED Fee Voucher Must either be currently registered in ABE classes, or have completed classes within the last 12 months. Must be Level 4 or above. Night Taxi / Dial-a-Ride Other (explain): FOR STUDENTS REQUESTING TRAVEL ASSISTANCE Verification of my physical address is attached. If I am approved for travel assistance and I move to a new address, I understand I must bring new verification to the Resource Center to continue to be approved for funds. 3
4 I am carpooling with other students to campus. I understand that only one student per carpool group is allowed to apply for travel reimbursement. Failure to report carpooling status may result in removal from this program and further disciplinary action. Names of students in carpool group: FOR STUDENTS REQUESTING CHILDCARE ASSISTANCE Must use state licensed daycare if approved. Do you receive childcare assistance from any other agency? Failure to report assistance from other agencies, may result in removal from this program and further disciplinary action. If yes, co-pay amount $ Please enter names and ages of children in household: 1. Age: 2. Age: 3. Age: 4. Age: Number of children assistance requested for: Section 2: Income Fill out tables below. Income documents should show the year-to-date income. Please make copies of these forms to attach to your application. For any income type that does not apply, enter a 0 or N/A in the box. Applications cannot be processed until all income verification documentation is submitted and all information is accurately entered below. If self-employed, a bank statement showing your Year-To-Date Income will be accepted as proof of income. Total number of people living in the home: Names of people in household Relationship to applicant Contributes income to household? 4
5 Section 2: continued Year-To-Date Income Type of Income Student s Income Other s Income Net pay (after taxes): Social Security income: TANF/GAU income: Unemployment income: Alimony/child support: Retirement income: Housing Assistance: Food stamps: Other income (e.g. Financial Aid) Total Income after Taxes $ $ Average Monthly Expenses Type of Expense Paid by Student Paid by Other House payment/rent: Car payment: Electric, phone, etc.: Food: Childcare expense: Child support payment: Auto/insurance: Gas/oil: Loan payments: Other expenses: Total Monthly Expenses $ $ 5
6 Section 3: Financial Aid Print the Financial Aid Portal, found under your MyCBC Home page. Use your social security number and your six-digit birth date to log in. Check that the Academic Year lists the correct year. Under the section Information We Need From You is a list of paperwork required to complete your financial aid file. Double-check that all paperwork has been turned in. If you have any questions about your financial aid, please speak with Hawk Central. Checkmark below to indicate your current status: Financial Aid information is attached Did not apply Not eligible for Financial Aid (circle one): ABE / ESL / GED / Running Start Other: Section 4: I authorize the release of information from any and all agencies. I will follow the procedures outlined in the approval letter, if I am approved for services. I understand that the Resource Center reserves the right to cancel assistance if procedures are not followed. My signature below confirms that the information provided in this application is correct, and permits the Resource Center to verify ALL information submitted. Applicant Signature: Date: Printed Name: FOR OFFICE USE ONLY APPROVED: RG AHorosky AHamill DENIED Notes: Columbia Basin College complies with the spirit and letter of state and federal laws, regulations and executive orders pertaining to civil rights, Title IX, equal opportunity and affirmative action. CBC does not discriminate on the basis of race, color, creed, religion, national or ethnic origin, parental status or families with children, marital status, sex (gender), sexual orientation, gender identity or expression, age, genetic information, honorably discharged veteran or military status, or the presence of any sensory, mental, or physical disability, or the use of a trained dog guide or service animal (allowed by law) by a person with a disability, or any other prohibited basis in its educational programs or employment. Questions or complaints may be referred to Camilla Glatt, Vice President for Human Resources & Legal Affairs and CBC s Title IX Coordinator at (509) Individuals with disabilities are encouraged to participate in all college sponsored events and programs. If you have a disability, and require an accommodation, please contact the CBC Resource Center at (509) or the Washington Relay Service at 711 or This notice is available in alternative media by request. 6
2018 Nursing Application Packet Program Application Fee $29
2018 Nursing Application Packet Program Application Fee $29 January 2, 2018 Dear Prospective Nursing Student: Thank you for your interest in the profession of nursing. This packet of information is being
More informationOPPORTUNITY GRANT APPLICATION
OPPORTUNITY GRANT APPLICATION Name CBC SID# APPLICATION COMPLETION CHECKLIST Initial each line and return this checklist with your completed Opportunity Grant application. Review Opportunity Grant eligibility
More informationNursing Assistant Program Application
Application Materials Program Overview Nursing Assistants (NAs) provide care to patients in a variety of healthcare settings for individuals that have difficulty performing their own basic care. Because
More informationOPERATING ENGINEERS Local Union #3 Joint Apprenticeship Committee For Hawaii
OPERATING ENGINEERS Local Union #3 Joint Apprenticeship Committee For Hawaii Kahuku Training Facility P.O. Box 428 56-1160 Kamehameha Hwy. Kahuku, Hawaii 96731-0428 (808) 232-2001 FAX (808) 232-2217 Dear
More informationFire Employment Application
North Dakota State University NORTH DAKOTA FOREST SERVICE Fire Employment Application Thank you for your interest in employment opportunities at the NDSU-North Dakota Forest Service. Please read the following
More informationPresent Address Telephone ( ) Street City State Zip. Permanent Address Telephone ( ) Social Security Number / / address
Application for Classified Personnel Minden Public Schools An Equal Opportunity/Affirmative Action Employer 543 West Third Phone: (308) 832-2440 Minden, NE 68959 Fax: (308) 832-2567 Please type or print
More informationOffice of Financial Aid Scholarship Application
Office of Financial Aid 2018-2019 Scholarship Application To be considered for any scholarship you must complete a 2018-2019Free Application for Federal Student Aid. FAFSA results must be in the financial
More informationMESA Summer Academy: Solar System Mission Possible Application Deadline: June 1, 2018 Early Bird Discount Deadline: May 1, 2018
MESA Summer Academy: Solar System Mission Possible Application Deadline: June 1, 2018 Early Bird Discount Deadline: May 1, 2018 Program Description Get a head start on your career in space exploration
More informationVOLUNTEER APPLICATION
Thank you for your interest in Estes Park Medical Center. The mission of the Estes Park Medical Center is to make a positive difference in the health and wellbeing of all we serve. VOLUNTEER APPLICATION
More informationAPPLICATION FOR EMPLOYMENT FIREFIGHTER / PARAMEDIC POSITION
FIRE DEPARTMENT BELLEVUE-DAYTON 514 Sixth Avenue, Dayton, Kentucky 41074 (859) 261-0083 www.fdbd.org For Office Use Only: Application Received: Application Date: Interview Date: APPLICATION FOR EMPLOYMENT
More informationKing and Queen County Treasurer 242 Allen s Circle, Suite H P O Box 98 King and Queen CH., VA (804) or (804)
King and Queen County Treasurer 242 Allen s Circle, Suite H P O Box 98 King and Queen CH., VA 23085 (804) 785-5978 or (804) 769-5004 APPLICATION FOR EMPLOYMENT Directions: Fill out this application in
More informationAPPLICATION FOR EMPLOYMENT. Directions: Fill out this application in its entirety using blue or black ink.
King and Queen County Office of the Commissioner of the Revenue 242 Allen s Circle, Suite I P O Box 178 King and Queen CH., VA 23085 (804) 785-5976 or (804) 769-5002 APPLICATION FOR EMPLOYMENT Directions:
More informationNeighborhood Services 900 W. Gentry Parkway Tyler, Tx Office (903) Fax (903) FAMILY SELF SUFFICIENCY ASSESSMENT QUESTIONNAIRE
1 Neighborhood Services 900 W. Gentry Parkway Tyler, Tx. 75702 Office (903)531-1303 Fax (903)531-1333 FAMILY SELF SUFFICIENCY ASSESSMENT QUESTIONNAIRE CITY OF TYLER HOUSING AGENCY DATE: / / A. DEMOGRAPHIC
More informationScholarship Application
2017-2018 Scholarship Application TO APPLY: COMPLETE AND SUBMIT ENTIRE SCHOLARSHIP PACKET. You only have to complete one application and will be considered for ALL scholarships you are qualified to receive.
More informationKirkland & Ellis New York City Public Service Fellowships at New York University School of Law and Columbia Law School
PERSONAL ESSAYS 1. State briefly the proposed goals of the public service project you wish to pursue as a Kirkland & Ellis Fellow. Please include in this statement a discussion of the short-term and long-term
More informationAPPLICATION FOR EMPLOYMENT
HUMAN RESOURCE USE ONLY Date: Reactivation Date: APPLICATION FOR EMPLOYMENT As an equal opportunity employer, it is Bradley University policy that all persons shall have equal employment opportunity regardless
More informationAPPLICATION FOR ADMISSION
APPLICATION FOR ADMISSION UPMC SCHOOLS OF NURSING APPLICATION FOR ADMISSION The following schools are part of the UPMC Schools of Nursing. Please list in order of preference which school of nursing you
More informationLast Name: First Name: Middle Name: Street Address: City: State: Zip Code: Home Phone: Work Phone: Cell Phone: May We Call You at Work?
City of Walker 205 Minnesota Avenue West PO Box 207 Walker MN 56484 218-547-5501 Employment application We welcome you as an applicant to employment! The City of Walker is an equal opportunity employer
More informationCity of Tomah Tomah Area Ambulance Service Employment Application
City of Tomah Tomah Area Ambulance Service Employment Application EMT Advanced EMT Paramedic Check Licensure Level Please complete this application if you wish to apply for employment with the City of
More informationIncomplete applications will not be considered.
Summer 2018 Accelerated BSN Application Packet Please note: You may only be considered for one program in any given application period. If you submit this application, we will not accept an application
More informationApplication for Employment Related Day Care (ERDC) Program
Application for Employment Related Day Care (ERDC) Program Please read these instructions before filling out this application. Answer all questions. Do not write in the shaded areas. To contact our office
More informationADMISSION INFORMATION
ADMISSION INFORMATION Lake-Sumter State College Nursing Program is a limited access program. Students must meet certain criteria before applications forward to the Nursing Selection Committee for admission
More information2018 CAMP Registration Packet. Boyertown YMCA PHILADELPHIA FREEDOM VALLEY YMCA
2018 CAMP Registration Packet Boyertown YMCA PHILADELPHIA FREEDOM VALLEY YMCA 1 Camp Registration Procedures 1. The entire camp registration packet minus the (optional) Request for Modification and Diabetes
More informationIndiana Energy Assistance Program Application Part 1. Personal Information
INSERT AGENCY LOGO 2017-2018 Indiana Energy Assistance Program Application Part 1. Personal Information Your Name Date of Birth First MI Last Social Security Number MM-DD-YYYY Current Home Address: Street
More informationState Trauma Program Coordinator $88,656 $110,088 annually, commensurate w/ training and experience
State of Hawaii Department of Health Emergency Medical Services and Injury Prevention System Branch Manoa Kahala, Oahu State Trauma Program Coordinator $88,656 $110,088 annually, commensurate w/ training
More informationCandidates failing to include ALL required documentation will be disqualified.
To All Police Officer Candidates: Thank you for your interest in employment with the City of South St. Paul! We anticipate hiring two officers immediately with additional opening(s) occurring during the
More informationRENTAL APPLICATION. Get Involved
RENTAL APPLICATION Get Involved To be completed by a potential resident. Please complete this rental application by typing or printing in ink. INCOMPLETE or UNSIGNED applications will not be considered.
More informationLake Washington Institute of Technology WINTER 2018 SPRING 2018 FALL 2018 Nursing AAS-T. Supporting Information for the Application Process
Lake Washington Institute of Technology WINTER 2018 SPRING 2018 FALL 2018 Nursing AAS-T Supporting Information for the Application Process INTRODUCTION Admission criteria for the Nursing AAS-T program
More informationCOMPEER PROGRAM VOLUNTEER APPLICATION
Spreading Hope, Spurring Action, Supporting Families, Saving Lives! COMPEER PROGRAM VOLUNTEER APPLICATION 3701 Latrobe Drive, Suite 140 Charlotte, NC 28211 Phone 704.365.3454 Fax 704.365.9973 Revised 7/13/2017
More informationChild Care Assistance Provider Agreement
Child Care Provider Information Iowa Department of Human Services Child Care Assistance Provider Agreement In order for you to receive payment under the Child Care Assistance Program, you must provide
More informationFREE TRAINING CAREER SUPPORT SERVICES
DOL H-1B Ready To W ork Grant FREE TRAINING CAREER SUPPORT SERVICES Upcoming Courses Will Include: Pr Funding for TWIC card is available Participating Partner CollegesTrainings Offered: CC RCrafts Project
More informationGENERAL APPLICATION FOR EMPLOYMENT
GENERAL APPLICATION FOR EMPLOYMENT Human Resources City of New Smyrna Beach 210 Sams Avenue New Smyrna Beach, Florida 32168 PLEASE PRINT OR TYPE Date of Application Position(s) Applied For The City of
More informationNetwork Security Specialist Course Selections (Grant Funded Tuition)
COURSE SELECTION FORM Network Security TAACCCT INTERFACE Grant Fall 2014 Instructions: 1. Download application* and Course Selection Form to a USB drive or your personal computer 2. Fill out the grant
More informationOffice of Institutional Diversity Inclusive Excellence Student Program Grant Call for Proposals Information
Academic Year: 2017-18 What is Inclusive Excellence? Office of Institutional Diversity Inclusive Excellence Student Program Grant Call for Proposals Information Inclusive excellence refers to the active
More informationApplication for Admission
Dear Applicant, Application for Admission WELCOME Thank you for your interest in Year Up Professional Training Corps Philadelphia! Please read the following pages for important information about our application
More informationKING AND QUEEN COUNTY
KING AND QUEEN COUNTY TREASURER S OFFICE DEPUTY 1 Applications are being accepted for the position of full-time Deputy 1 to work in the King and Queen County Treasurer s Office located in the King and
More informationLIHEAP and Weatherization Application and Required Documentation Check List
Application and Required Documentation Check List Energy Intake Form CSD43: Completed, signed and dated in blue or black ink. Do not use white out. GNS Application: Completed in blue or black ink. Information
More information2018 Scholarship Application and Information for IEEE TryEngineering Summer Camps
2018 Scholarship Application and Information for IEEE TryEngineering Summer Camps Scholarship Information The TryEngineering Summer Camp Scholarship is a need based scholarship that offers financial assistance
More information2018 CAMP Registration Packet. Roxborough YMCA PHILADELPHIA FREEDOM VALLEY YMCA. Important Registration Information:
2018 CAMP Registration Packet Roxborough YMCA PHILADELPHIA FREEDOM VALLEY YMCA Important Registration Information: Financial Aid Applications are due no later than 2 weeks before desired camp start date.
More informationCITY OF NEW BEDFORD APPLICATION FOR EMPLOYMENT PERSONNEL DEPARTMENT 133 WILLIAM STREET, ROOM 212 NEW BEDFORD, MA (508)
CITY OF NEW BEDFORD APPLICATION FOR EMPLOYMENT PERSONNEL DEPARTMENT 133 WILLIAM STREET, ROOM 212 NEW BEDFORD, MA 02740 (508) 979-1444 For Office Use Only Initials Mail Office The City of New Bedford has
More informationLake Washington Institute of Technology WINTER SPRING FALL Nursing AAS-T Application and Forms
Lake Washington Institute of Technology WINTER SPRING FALL 2017-18 Nursing AAS-T Application and Forms This document contains the application form for the Nursing AAS-T program. It should also be used
More informationPeoria Heights Fire Department. Membership Application Packet
Peoria Heights Fire Department Membership Application Packet Please turn in all completed applications in a sealed envelope to the Village Administration office during normal business hours, or mail to
More informationIT 3 Grant Funding FREE!! TRAINING AND CERTIFICATION EXAMS IT 3 SCHOLARS RECEIVE THE FOLLOWING:
IT 3 Grant Funding BECOME AN IT 3 SCHOLAR BEFORE IT S TOO LATE!!! FREE!! TRAINING AND CERTIFICATION EXAMS IT 3 SCHOLARS RECEIVE THE FOLLOWING: UP TO 2 CLASSES & 2 CERTIFICATION EXAMS PAID FOR BY THE IT
More informationLast Name First Middle Initial Maiden Name (if applicable)
Application For Sheriff Deputy Employment PLEASE PRINT IN INK OR TYPE Marinette County Human Resources 1926 Hall Avenue Marinette, WI 54143-1717 Marinette County is an equal opportunity employer. All hiring,
More informationCATHERINE FUND FINANCIAL AID APPLICATION March 2016
GUIDELINES/ QUALIFICATIONS FOR Please read all Guidelines, Policies and Procedures, and Instructions before completing application. You must meet all guidelines for your application to be considered. 1.
More information2016 LPN Advanced Placement Application. For Fall 2017 Entry, Second Year, Nursing Program
Umpqua Community College 2016 LPN Advanced Placement Application For Fall 2017 Entry, Second Year, Nursing Program Please email roger.sanchez@umpqua.edu to reserve a seat for the required Elsevier s HESI
More informationDOL H1B IT 3 Grant Funding FREE!! TRAINING AND CERTIFICATION EXAMS IT 3 SCHOLARS RECEIVE THE FOLLOWING:
IT 3 Grant Funding FREE!! TRAINING AND CERTIFICATION EXAMS SAP - Human Resources SAP - Materials Management Ethical Hacking & Pen Testing Cloud Computing ITIL Bootcamp Network+ Bootcamp BECOME AN IT 3
More informationPLAY Application Checklist
PLAY Application Checklist Use the following checklist to ensure you complete all steps before you submit your application. Incomplete applications cannot be accepted. Applicant Are You a Denver Resident?
More informationLast Name First Name M.I. Name You Prefer. City State Zip Address. Daytime Phone Evening Phone Best Time to Call. City State If yes, where?
GENERAL INFORMATION Last Name First Name M.I. Name You Prefer Mailing Address How long at this address? City State Zip County If less than a year, previous address How long have you resided in the county?
More information2017 ADDENDUM TO THE MEMBER HANDBOOK (formerly known as Evidence of Coverage (EOC)) FOR PREPAID MEDICAL ASSISTANCE PROGRAM (PMAP)
HealthPartners Member Services MS 21103R 8170 33rd Avenue South P.O. Box 9463 Minneapolis, MN 55440-9463 Telephone: 952-967-7998 or 1-866-885-8880 (toll free) TDD/Hearing Impaired: 952-883-6060 or 1-800-443-0156
More informationCleveland TGA Service Standard of Care
SERVICE CATEGORY DEFINITION Services: is the provision of nonemergency transportation services that enables an eligible client to access or be retained in core medical and support services. Medical transportation
More informationDOCTOR OF NURSING PRACTICE PROGRAM. Graduate Application and Admission Information
DOCTOR OF NURSING PRACTICE PROGRAM Graduate Application and Admission Information APPLICATION INSTRUCTIONS FOR THE FALL 2018 COHORT GROUP Please complete and mail your application to the Office of Graduate
More informationAlzheimer s Arkansas is pleased to provide you with information about the Family
PLEASE READ ALL INFORMATION INCLUDED IN THIS GRANT APPLICATION Dear Caregiver: Alzheimer s Arkansas is pleased to provide you with information about the 2016-2017 Family Caregiver Support Program. Funding
More informationApplication for Employment An Equal Opportunity / Affirmative Action Employer
Human Resource Office MS # 40966 Application for Employment An Equal Opportunity / Affirmative Action Employer 2011 Mottman Road SW Olympia, WA 98512 (360) 596-5500 FAX: (360) 596-5706 e-mail: jobline@spscc.edu
More informationEIGHTH DISTRICT COURT OF APPEALS OF OHIO 1 Lakeside Avenue, Cleveland, Ohio EMPLOYMENT APPLICATION PERSONAL DATA
EIGHTH DISTRICT COURT OF APPEALS OF OHIO 1 Lakeside Avenue, Cleveland, Ohio 44113 www.appeals.cuyahogacounty.us EMPLOYMENT APPLICATION It is the policy of the Eighth District Court of Appeals to provide
More informationVerification Overview
Verification Overview Kevin Dawson, August 2, 2016 USDA Non-Discrimination Statement In accordance with Federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies,
More information!!! Program Referral Checklist. Assessment for Determining Eligibility. Vocational Rehabilitation Needs. Medical and Psychological Reports
Initial Documentation Referral Form (attached) Program Referral Checklist Assessment for Determining Eligibility Vocational Rehabilitation Needs Medical and Psychological Reports School Transcripts and/or
More information2018 State Funded Youth Employment Program
2018 State Funded Youth Employment Program APPLICATION OF INTEREST Completion of this application does not guarantee a slot in the program. This program is currently PENDING funding. Youth will be notified
More informationDOL H1B-Gulf Coast Ready To Work Petrochem Grant
DOL H1B-Gulf Coast Ready To Work Petrochem Grant FREE TRAINING CAREER SUPPORT SERVICES Upcoming courses will include: NCCER Welding NCCER Pipefitting Engineering Design Graphics Non-Destructive Testing
More informationPERMANENT 4-H RECORD Level 2
PERMANENT 4-H RECORD Level 2 Begin this record when you are ready to move from Level 1 to Level 2. Write down things as you do them. C0935 Name: Date this record started: Date ending this record: Offices
More informationDOL H1B-Gulf Coast Ready To Work Petrochem Grant
FREE TRAINING DOL H1B-Gulf Coast Ready To Work Petrochem Grant CAREER SUPPORT SERVICES Upcoming courses will include: PAID INTERNSHIPS Welding Project Management Professional Pipefitting Lean Six Sigma
More informationYour application will be considered complete once you have included the following documents with your campus apartment application.
Sitting Bull College Efficiency Apartment Application 9299 Highway 24 Fort Yates, ND 58538 Listed below is the required information that is needed for Sitting Bull College (SBC) efficiency apartments.
More informationPHILLYSEEDS SCHOLARSHIP PROGRAM APPLICATION REQUIREMENTS AND CHECKLIST
PHILLYSEEDS SCHOLARSHIP PROGRAM APPLICATION REQUIREMENTS AND CHECKLIST ELIGIBILITY Seeking full-time admission to a two-year or four-year college, university or trade/technical school; GPA of at least
More informationGENERAL APPLICATION FOR EMPLOYMENT Human Resources City of New Smyrna Beach 210 Sams Avenue New Smyrna Beach, Florida 32168
GENERAL APPLICATION FOR EMPLOYMENT Human Resources City of New Smyrna Beach 210 Sams Avenue New Smyrna Beach, Florida 32168 PLEASE PRINT OR TYPE Date of Application Position(s) Applied For The City of
More informationCommunity Emergency Response Team (CERT) Volunteer Application Douglas County Citizen Corps Council Douglas County Sheriff s Office
Community Emergency Response Team (CERT) Volunteer Application Douglas County Citizen Corps Council Douglas County Sheriff s Office PLEASE TYPE OR PRINT FULLY ANSWER ALL QUESTIONS USE INK ONLY An Incomplete
More informationDIRECT CERTIFICATION/ DIRECT VERIFICATION SEARCH PAGE FOR CE LEVEL MATCHES
DIRECT CERTIFICATION/ DIRECT VERIFICATION SEARCH PAGE FOR CE LEVEL MATCHES OVERVIEW Direct Certification is a simplified method of determining student s eligibility for free meals through the National
More informationWayzata Fire Department 600 East Rice Street Wayzata, Minnesota (952)
Wayzata Fire Department 600 East Rice Street Wayzata, Minnesota 55391 (952) 404-5337 Dear Prospective Applicant, Thank you for inquiring about joining our Fire Department. We appreciate your interest in
More informationMILLERS COLLEGE OF NURSING
Congratulations on your decision to pursue your degree in nursing. The Millers College of Nursing offers a career pathway to meet the needs of individuals who are interested in obtaining the baccalaureate
More informationRogue Community College. 2018/19 Nursing Program Application. For Fall 2019 Entry
Rogue Community College 2018/19 Nursing Program Application For Fall 2019 Entry Applications will be accepted starting November 1, 2018. STEP ONE: Complete the online portion of the application available
More informationEmmanuel Hospice. Welcome to Emmanuel Hospice! Please follow these step by step directions to submit your application:
Emmanuel Hospice St. Ann s Clark Porter Hills Sunset 2161 Leonard St. NW Grand Rapids, MI 49504 P. 616.719.0919 F. 616.719.0933 www.emmanuelhospice.org Welcome to Emmanuel Hospice! Please follow these
More informationPractical Nurse. Application timeline. Admission process
Practical Nurse This one-year certificate program combines classroom instruction, laboratory experience and clinical practice to prepare students to care for patients in a variety of settings. Students
More informationSACRED HEART PARISH LA GRANGE, TEXAS
SACRED HEART PARISH LA GRANGE, TEXAS DIOCESE OF AUSTIN ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
More informationOriginal Effective Date: April Policy Number 0.0. Page Last Revision Date: October of 6 Revision Effective Date: January 2016
Subject: Alaska Charity Care Policy Original Effective Date: April 2011 Page Last Revision Date: October 2015 1 of 6 Revision Effective Date: January 2016 Authorization: VP Revenue Cycle Policy Number
More informationSPRING BRANCH COMMUNITY HEALTH CENTER
Hillendahl Clinic 1615 Hillendahl Blvd., Suite 100 Houston, TX 77055 (713) 462-6565 Pitner Clinic 8575 Pitner Road Houston, TX 77080 (713) 462-6545 Mon, Wed, Fri: 8am-5pm Tues & Thurs: 8am-8pm 1 st & 3
More informationSUPPLEMENTAL INFORMATION PACKET FOR Anti-Discriminatory Housing Policy
SUPPLEMENTAL INFORMATION PACKET FOR Anti-Discriminatory Housing Policy Planning Department 1650 Mission Street Suite 400 San Francisco, CA 94103-9425 T: 415.558.6378 F: 415.558.6409 Pursuant to Administrative
More informationYMCA PRIMETIME PARENT/GUARDIAN:
START DATE: YMCA PRIMETIME RATE: Enrollment Form 2018-2019 SITE: Does your child have food allergies? Circle YES or NO Child s Name Gender Race Age Date of Birth Home Address, City, State, Zip Home Telephone
More information2018 City of Pompano Beach. Blanche Ely Scholarship Program
2018 City of Pompano Beach Blanche Ely Scholarship Program 1 2018 CITY OF POMPANO BEACH BLANCHE ELY SCHOLARSHIP Available Scholarships Four (4), two (2)-year (60 credit hour) scholarships Application Deadline
More informationUCare Connect (Special Needs BasicCare) Enrollment Form
UCare Connect (Special Needs BasicCare) Enrollment Form UCare Connect Enrollment Telephone Numbers 612-676-3554 or 1-800-707-1711 toll free. TTY for the hearing impaired at 612-676-6810 or 1-800-688-2534
More informationNEW SCHOOL NURSE ORIENTATION Friday, August 10, 2018 Mount Mercy University Graduate Center 1650 Matterhorn Dr, NE Cedar Rapids, Iowa
NEW SCHOOL NURSE ORIENTATION Friday, August 10, 2018 Mount Mercy University Graduate Center 1650 Matterhorn Dr, NE The New School Nurse Orientation brings together a faculty with experience in school health
More informationNON-TEACHING APPLICATION
WA-NEE COMMUNITY SCHOOLS 1300 North Main Street Nappanee, IN 46550-1015 For Office Use Only Interview (date & time) Reference Check Expanded Criminal Background Check Drug Test Sexual Offender Check CPS
More informationPrairie City EMS Department. EMS Department 203 E. Jefferson Street Prairie City, Iowa 50228
Prairie City Fire Department EMS Department 203 E. Jefferson Street Prairie City, Iowa 50228 Member Application Package Thank you for your interest in becoming a member of the Prairie City Fire Department
More informationAPPLICATION FOR EMPLOYMENT
APPLICATION FOR EMPLOYMENT Applicants for a home care aide position must have a current DC home health aide certification or had at least 125 hours of Home Care Aide training. Applicants for a CNA position
More informationFort Bend County M A S T E R G A R D E N E R A P P L I C A T I O N
Fort Bend County M A S T E R G A R D E N E R A P P L I C A T I O N Please complete all Sections of this Application thoroughly! Fall 2017 Class begins October 10, 2017 Location: Texas A&M AgriLife Extension
More informationAPPLICATION FOR EMPLOYMENT
Please print clearly and in ink. If you need assistance in completing this application, please let us know so that we can discuss a reasonable accommodation. RECRUITING DATA How did you hear about this
More informationCrandall Fire Department
Crandall Fire Department Membership Application Today s Date Please Print or Type all information. All printing must be in BLUE ink. Omissions and/or false information are cause for rejection or dismissal.
More information2018 Lodging Tax Fund City of Cle Elum 101 West First Street Cle Elum, WA
Request for Proposals 2018 Lodging Tax Fund City of Cle Elum 101 West First Street Cle Elum, WA 98922 509-674-2262 2018 Lodging Tax Funds General Information The City of Cle Elum imposes a lodging tax
More informationZOO CREW JUNIOR DOCENT VOLUNTEER APPLICATION
ROGER WILLIAMS PARK ZOO AND RHODE ISLAND ZOOLOGICAL SOCIETY ZOO CREW JUNIOR DOCENT VOLUNTEER APPLICATION PEOPLE MAKE THE DIFFERENCE AT THE ZOO Please mail completed application to: Manager of Volunteer
More informationSCHOLARSHIP APPLICATION VFW POST 311 Commander s Scholarship 2018
SCHOLARSHIP APPLICATION VFW POST 311 Commander s Scholarship 2018 1. DEADLINE for scholarship applications is Friday July 1, 2018 (NO EXCEPTIONS). 2. Refer to application process below for a list of the
More informationEMPLOYMENT APPLICATION & INSTRUCTIONS
EMPLOYMENT APPLICATION & INSTRUCTIONS An Equal Opportunity Employer Lander County Sheriff s Office P.O. Box 1625, Battle Mountain, NV 89820 (775) 635-1100 ~~ FAX (775) 635-2577 If you believe you require
More information2016 GFWC Success for Survivors Scholarship
The General Federation of Women s Clubs is a national leader in the fight to end domestic violence. To emphasize our dedication in tackling this societal issue, GFWC implemented the Success for in 2011.
More informationApplication For Employment
Application For Employment We consider applicants for all positions without regard to race, color, religion, creed, gender, genetics, national origin, age, disability, marital or veteran status, sexual
More informationApplication for Employment. Page 1 07/18
Application for Employment Page 1 Dear Applicant, Thank you for expressing interest in the Washington State University Cougar Security Program. The following outline should help you understand the program,
More informationFIRE RECRUIT CIVIL SERVICE COMMISSION CITY OF TYLER, TEXAS MINIMUM QUALIFICATIONS
>0?.\. CIVIL SERVICE COMMISSION CITY OF TYLER, TEXAS Announces an Examination for FIRE RECRUIT ANNOUNCEMENT OPENS: THURSDAY, JULY 19, 2018 AT 9:30 A.M. APPLICATION DEADLINE: FRIDAY, AUGUST l7, 2018 AT
More informationSTEM Pilot Project Grant Program
REPORT TO THE LEGISLATURE STEM Pilot Project Grant Program June 2016 Authorizing legislation: Capital Budget, Chapter 3, Laws of 2015, 3rd Special Session (http://des.wa.gov/sitecollectiondocuments/facilities/eas/2016-
More informationBID SHSGA CACFP CONTRACT #03309 FY2015 ADVERTISEMENT FOR FOOD PROCUREMENT FOR KIDS CAFÉ PROGRAM
BID SHSGA CACFP CONTRACT #03309 FY2015 ADVERTISEMENT FOR FOOD PROCUREMENT FOR KIDS CAFÉ PROGRAM Second Harvest of South Georgia, Inc. ( SHSGA ) is accepting Sealed Bids from qualified food vendors for
More informationOnce the application and all of the required information has been gathered, send the documents and the application to the Bloomington SCCAP office.
Dear Energy Assistance Applicant, Enclosed you will find your application for the 2012-2013 Energy Assistance Winter Program. Please read through all of the information included inside this packet. We
More informationMEDICAL & DENTAL. Mabuhay! neighborcare.org
MEDICAL & DENTAL Mabuhay! neighborcare.org Mabuhay! Mabuhay! Welcome to Neighborcare Health Meridian Center for Health Neighborcare Health at Meridian is located within the Meridian Center for Health,
More informationSchools Grant Application Instruction and Form
Schools Grant Application Instruction and Form Thank you for your interest in applying for a schools grant. This grant opportunity is intended to help fund one time programs and/or projects. Enclosed you
More informationSlide 1. USDA Civil Rights and Child Nutrition Programs
Slide 1 USDA Civil Rights and Child Nutrition Programs USDA Civil Rights Requirements and Child Nutrition Programs. This training presentation is developed and provided by the Oregon Department of Education.
More informationAdmission Requirements
Admission Requirements All Applicants: ATI TEAS V entrance exam is required for ALL applicants in addition the requirements listed below. Applicants must have at least a 60% Adjusted Individual Total Score
More information