BFE&T Application
2009·2010 STUDENT INFORMATION
LAST NAME
FIRST
M.I.
SOCIAL SECURITY NUMBER
COMPLETE MAILING ADDRESS
DAY PHONE
STUDENT ID NUMBER
(
EVENING PHONE
I
BIRTHDATE
DATE OF APPLICATION
I
)
(
)
EMAIL ADDRESS
GENERAL INFORMATION ­ Please circle YES or NO
Are receiving Basic Food?
YES NO
. Are you receiving TANF? YES NO
When did you submit your Admissions Application?
Have you completed the FAFSA for the 2009/2010 ?
Have you attended a college or university? YES NO
My program requires an Accuplacer score YES NO
Where did you attend?
My Accuplacer appointment is on _ 1_ 1_
Have you earned any certificates or degrees? YES NO
I have taken the Accuplacer YES NO
If YES, please list
Are you a veteran? YES NO
If YES, do you have an honorable discharge within the past
two years?
Have you received unemployment benefits within the past two years?
YES NO
Bellingham Technical College provides equal opportunity in education, employment, and access to all persons. Inquiries regarding compliance with access, equal
opportunity, and/or grievance procedures should be directed to Human Resources, Building A Room A2, at (360) 752-8354 or 752-85 I 5/TTY.
Please answer all of the questions on this application to the best of your ability. Each question should be
answered with 3-5 complete sentences.
1. Program of study _ _ _ _ _ _ _ _ _ _ _ _ __
Start date: (month / year) _ _ _ __
Projected end: (month / year) date _ _ _ _ _ _ __
2. Please describe your career goals.
a. What specific occupation are you working toward?
b. What degree or other credentials are required for that occupation?
c.
What do you expect to be doing after 10-15 years in that occupation?
3.
Please list your top five strengths and abilities related to work and learning.
a.
b.
c.
d.
e.
f. Explain how your skills and experiences can be applied to your chosen career.
4. . Consider any possible challenges you may encounter while attending college. Specifically address the following:
a. Describe your existing support system (family, friends, and professional services) and how they will help
you navigate personal challenges and family obligations while you are in school. If you will be working
while attending school, how will you balance those schedules?
5.
b.
Academic: Describe any concerns you may have about meeting the academic challenges you may
experience with college-level work.
c.
Financial: What steps have you taken or do you plan to take, to secure funding for education? If you are
not eligible for traditional financial aid (FAFSA), please explain why.
Please tell us about anything else you believe we should take into consideration while reviewing your application.
NORTHWEST PARTNERSHIP FOR WORKFORCE DEVELOPMENT
AUTHORIZATION FOR RELEASE OF INFORMATION
I,
, Social Security Number
, authorize the agencies I
have initialed below to share employment, unemployment, education and training related information among
the agencies I have initialed. The information shall only be shared for the purpose of providing me employment
and education/training related services. Other use of my confidential information is prohibited by law.
INITIAL
AGENCIES
SPECIFIC INFORMATION TO BE SHARED
REQUIRED
'----__ Bellingham Technical College
_ _ _ Dept of Social and Health Services/CSO
_ _ _ Employment Security Department
_ _ _ Workforce Development Council
---
Division of Vocational Rehabilitation
OPTIONAL
_ _ _ Skagit Valley College
_ _ _ Whatcom Community College
_ _ _ Opportunity Council/Community Action
_ _ _ Job Corp
---
Opportunities Industrialization Center
_ _ _ Other (please specify:
)
I understand it is my right to withhold authorization. Withholding consent will in no way affect my eligibility
for services. I also understand that I may cancel this authorization in writing, at any time, except to the extent
that the hold of information/records has already taken action in reliance on the authorization.
This consent does not release medical, HIV/AIDS related information or Alcohol/Drug related information.
Signature of client
Date
Signature of Parent or Guardian
Specified Expiration Date
I have received a copy of this release- - - -
Client Initials
Agency Contact
Bellingham Technical College
Agency
Title
BFE&T Grant Information
(Basic Food, Employment and Training)
**Now accepting applications for 2009-2010
The BFE&T program is designed to help low income students get prepared for and enter programs at Bellingham
Technical College that will result in high demand, high wage occupations.
Eligibility criteria:
•
•
Receiving Basic Food (food stamps) assistance
Basic Food income eligibility (see chart)
Monthly Gross
Annual Gross
Income limit
Income limit
1
$1,733
$20,800
2
$2,333
$28,000
3
$2,933
$35,200
4
$3,533
$42,400
5
$4,133
$49,600
6
$4,733
$56,800
Family Size
For each additional person, add $7,200 per year
•
Priority
1)
2)
3)
given to students who: Are not eligible for Financial Aid (FAFSA) Are enrolled in high cost programs Not fully funded through other types of aid Grant recipients may receive:
•
•
•
Tuition and fees for up to 45 college level credits
Required books and tools
Limited support for child care, bus passes, and emergencies
How to Apply: All completed applications must be received by Student Financial Resources by mail or hand delivery NO LATER THAN 5PM, MONDAY, AUGUST 31ST. Please complete the following. 1. Applications are available for pick up starting Monday, August 3rd
2. BFE&T Application
3. Release of Information
4. WASHINGTON STATE SELF-SUFFICIENCY CALCULATOR, (HTTP://WWW.THECALCULATOR.ORG/)
PRINTED AND ATTACHED.
Questions? Contact either of the following people:
David Knapp, BFE&T Coordinator
(360) 752-8492
dknapp@btc.ctc.edu
or
Andie Whitewing, BFE&T Office Coordinator
(360) 752-8379
awhitewing@btc.ctc.edu