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Applicant Information
Birthday
Year
Month
Day
2. Parent / Guardian / Support Person
Do you have a parent, guardian, family member or support person you would like involved in the application?
Yes
No
Legal Guardian
Yes
No
Not Applicable
Applicant consents to Bridge to Care contacting this person regarding this application:
Yes
No
PDD / Funding Information
Are you currently eligible for or receiving Persons with Developmental Disabilities (PDD) services?
Yes
No
Application in Progress
Unsure
 Education Information
Highest level of education completed:
High School
High School Certificate
Currently attending High School
College/Post-Secondary Experience
Other
 Post-Secondary Interests
Which areas are you interested in studying or experiencing?
Preferred college/university or community (In the order of preference):
 Strengths and Interests
Support Needs
Please identify areas where you may benefit from support:
Campus & Social Participation
Campus & Social Participation
Classes
Student clubs
Sports/Recreation
Campus events
Volunteering
Employment/Work Experience
Social activities
Other
Employment & Future Goals
Are you interested in employment during or following your post-secondary experience?
Yes
No
Unsure
Do you anticipate needing transportation-related support?
Yes
No
Unsure
Transportation
How would you normally travel to campus?
Public Transit
Family/Support Person
Drive Myself
Accessible Transportation
Other
Preferred Start
When would you like to begin?
As soon as possible
Fall Semester
Winter Semester
Next Academic Year
Other
Additional Information
Applicant Declaration & Consent
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