Education & Training Voucher Application

Student Name: ______
School: ______

Semester: ______Year: ______

Education & Training Voucher Application

ETV APPLICATION
Youth Name: Click here to enter text. / Interview Date: Click here to enter a date.
Youth Address: Click here to enter text. / Youth Phone: Click here to enter text.
City: Click here to enter text.
State: Click here to enter text. / Alternate Phone: Click here to enter text.
Zip Code: Click here to enter text.
Youth E-Mail Address:
Click here to enter text. / Application Submitted:
Click here to enter a date. / Has the student completed the Free Application for Federal Student Aid (FAFSA)?
Yes NO
Application Completed: Click here to enter a date. / Interview Type: Choose an item.
EDUCATIONAL GOALS
Student’s Educational Goals:
Choose an item. / What type of educational program does the student plan to enroll in?
Choose an item.
What School is the student currently attending or enrolled in:
Click here to enter text. / What is the current Grade Level of the student?
Choose an item.
Is the student currently enrolled or planning to enroll as a full-time or part-time student?
Choose an item. /
What is the student’s declared Major (e.g. English, Political Science, etc.)?
Click here to enter text.
If they are a returning student, how are their classes going (Academic Progress)?
Choose an item.
When does the student expect to graduate? Click here to enter a date.
STUDENT PROFILE
Does this student have a Drivers License?
Choose an item. / What is the current living arrangement of the applicant?
Choose an item.
Does the student consider it to be stable, safe, and appropriate?
Yes NO / If applicant answered NO to the previous question, this issue must be addressed immediately regardless of ETV eligibility
Does the student need any assistance in the area of housing?
Yes NO / If yes in what area? Choose an item.
Is the student currently employed?
Yes NO / Full-time or part-time?
Choose an item. / Name of Employer?
Click here to enter text.
Is employment interfering with schoolwork?
Yes NO / Is employment considered something appropriate and needed at this time?
Yes NO
Who does the student describe as his/her supports? Click here to enter text. / Does the student have support from a positive adult/friend?
Yes NO
Are there any other formal supports in place? Choose an item. / Follow-up required by ETV staff:
Click here to enter text.

Additional Comments: Click here to enter text.

I certify that the above information is true to the best of my knowledge.

X______

Student Date: Click here to enter a date.

X______

TYS Coordinator/ ETV Staff Signature Date: Click here to enter a date.

ETV Financial Aid Release Form
First Name: ______ / Last Name: ______
Student Id:
______ / Phone:
(___) ____-______ / Cell Phone:
(___) _____-______ / Last Four Digits of SSN#:
______
I am applying for the Education and Training Voucher Program (ETV), a federally funded program administered by the Arkansas Department of Human Services (DHS) and authorize the financial aid office to release my financial aid information to Arkansas Department of Human Services representatives.
X______
Student Signature /
Date: ____/____/______

To Be Completed By Representative of Financial Aid Office Only

Current Semester Financial Information
School/University Name: ______ /
Payment Address: ______
______
______
______
Student Status: Full-Time Part-Time / Current Semester: Fall Spring Summer I Summer II
Total # of hours enrolled in this Semester: _____ / Has student completed FAFSA? Yes No
Pell Grant Award Amount: $______
* If student is ineligible for the Pell Grant indicate reason why /
Academic Probation
Less than Part-Time Status
Estimated Family Contribution (EFC)
Other:______
Total Cost of Tuition :$______ / Subsidized Loans: / Offered / Amount:$______
Accepted Declined / Amount:$______
Unsubsidized Loans: / Offered / Amount:$______
Accepted Declined / Amount:$______
Work Study: / Accepted Declined / Amount:$______
Cost of Housing:$______
*Only complete if student is residing on campus / On- Campus Housing:
Yes No / Dormitory
Campus Apartment
Other:______
Off-Campus Housing:
Yes No / Off-Campus Apartment
Parent/Guardian
Other:______
Cost of Meal Plan:$______
* Only complete if student is residing on campus
Grants/Scholarships: / 1. / Amount:$______
2. / Amount:$______
3. / Amount:$______
Total Cost of Attendance
Including tuition, fees, room & board, transportation, books & supplies /
Amount:$______
Prepared By: X______ / Print Name: X______ / Date: ______
Phone Number: (____)______ /
Email Address: ______

Fax Completed Form To:

Attn: Arkansas ETV
501-683-1664
Questions?
Email:

ETV Application CHECKLIST

The following information is needed to complete your ETV application:

Completed ETV or ETV Re-determination Application
Copy of current Class Schedule

Copy of Financial Aid Release Form (Must be completed by Representative of Financial Aid office)
Bill/Invoice (From Business Office)

Transcript (unofficial) with cumulative Grade Point Average (GPA)

Completed & signed “Statement of Responsibility Form” (Student)

Return completed applications to the email address listed below or fax them to

Fax #: 501-683-1664

------

FOR ETV OFFICE USE ONLY
Date Processed:
Click here to enter a date. / Eligibility:
Choose an item. / Amount Requested:
Click here to enter text. / Amount Approved: Click here to enter text.
Chafee $______
ETV $______
Purpose: Choose an item. / Other Information: Click here to enter text.

ETV Frequently Asked Questions

How do I receive my ETV award for next semester?

You can be awarded an ETV grant up to $2,500 each semester (as long as funding is available). In order to get your second award amount for this academic year, please make sure to complete the Checklist for Re-Determination (ETV Part II) form. You can get this form from your Transitional Youth Services Coordinator or Family Service Worker, or online at http://humanservices.arkansas.gov/dcfs/Pages/dcfsPublications.aspx. The proper form will need to be completed prior to the beginning of each semester in addition to submitting the required documents listed on the “ETV Checklist”.

What can my ETV award be used for?

ETV money will first pay for any tuition and fees that are owed to the school. After that, ETV can pay for anything related to your educational needs; including student loans, housing, transportation, computers, school supplies, daycare expenses and anything else that is going to assist you with completing your education. If you are unsure if an expense is allowable, please contact your Transitional Youth Services Coordinator or your Family Service Worker. They can provide you with a copy of an “Allowable Expenditures” sheet outlining commonly approved purchases.

How will I re-apply Next Year?

When re-applying next year, you will need to complete the ENTIRE ETV application packet again. You are not automatically enrolled to be re-awarded because you received previous ETV awards.

What will I need to send in to re-apply?

In addition to completing the application packet again, you will need to provide your grades, including your Cumulative Grade Point Average (GPA), which needs to be above a 2.0. You also need to send in receipts showing how your ENTIRE current ETV was spent. Without both of these items, you will not be re-awarded.

What happens if I do not complete the classes I was enrolled in?

When you re-apply, we will not only look at your GPA, but also look at the completion of your classes. Please be aware, if you have an incomplete or withdrew from more than ONE class per semester, you will not be awarded again until you complete a full semester. This means that, although your GPA may be above a 2.0, you are not guaranteed to be re-awarded.

What do I do if I move or change phone numbers?

You MUST contact the ETV Office when your contact information, including your mailing address and/or phone number changes. An ETV representative will be contacting you on a regular basis and they need to be able to get in touch with you. In addition, we also occasionally send out mailings to inform you of additional funding and resources, and these often have deadlines. If we can’t reach you, you cannot be fully informed.

How do I get in touch with the ETV office when I want to send in information?

You can call the office at 501-683-2447. Our fax number is 501-683-1664

Resources Available to Youth Pursuing a College Degree in Arkansas

Free Application for Federal Student Aid

All students must complete the Free Application for Federal Student Aid (FAFSA). Students can access online at http://www.fafsa.ed.gov or by calling the Federal Student Aid Information Center at 1-800-4-FED-AID. In order to receive the Pell grant for low-income students, loans or other aid, the student MUST complete the FAFSA prior to applying for the ETV scholarship program.

The Arkansas Challenge Scholarship

The Academic Challenge Program provides scholarships to Arkansas residents pursuing a higher education. The program is primarily funded by the Arkansas Scholarship Lottery. The Academic Challenge Scholarship is available to students regardless of their academic status, whether just graduating from high school, currently enrolled in college, enrolling in college for the first time, or re-enrolling after a period of time out of college. Visit https://www.ark.org/adhe_financialaid/Login.aspx to complete the online application.

The Arkansas Education and Training Vouchers (ETV)
ETV provides up to $5,000 towards school-related costs and living fees. It is for youth that were in foster care after the age of 14. Contact your local DHS office, your Transitional Youth Services Coordinator, your Family Service Worker or the state ETV office at (501) 683-2162.

Casey Family Scholars Program
Casey provides scholarships of up to $10,000 for young people who spent at least 12 months in foster care and were not subsequently adopted. Check the OFA website at www.orphan.org .

Ellen Carpenter HBCU Scholarship

The Ellen Carpenter HBCU Scholarship Program is named for Ms. Ellen Carpenter, a graduate of Philander Smith and a long-time education and community activist and is available for students attending one of the following participating Arkansas Historically Black Colleges and Universities (HBCUs): Arkansas Baptist College, Philander Smith College or the University of Arkansas at Pine Bluff. The award amounts vary from $1000 to $5000 per year. Contact the financial aid offices for more information.

Governor’s Scholars Program

Up to $4000 annually for graduating high school seniors based on academic achievement, test score and leadership. The Governor’s Distinguished Scholarship for those scoring 32 on the ACT or 1410 on the SAT, and a 3.50 academic grade point average, or are named National Merit Finalists or National Achievement Scholar pays tuition, mandatory fees, room and board up to $10,000 per year. Complete YOUniversal Scholarship Application at https://www.ark.org/adhe_financialaid/Login.aspx.

Higher Education Opportunities Grant (GO! Opportunities Grant)

Go! Grants provide $1,000 grants to full-time and $500 grants to part-time students based on their financial need. Students must be an Arkansas resident for at least 12 months prior to applying for the grant. Students also must meet the financial need criteria established for the GO! Grant and attend an approved Arkansas institution. Applicants complete the Free Application for Federal Student Aid (FAFSA) and the GO! Opportunities Grant application. Complete the YOUniversal application at https://www.ark.org/adhe_financialaid/login.aspx.

GED Scholarship
Awarded to first time entering students who score an average of 600 on the GED exam. Student must have taken the GED at an Arkansas test center. This scholarship may be renewed up to four semesters if a 3.0 GPA is earned each semester with full-time enrollment (12 hours or more). Amount: Tuition & Fees Deadline to Apply: August 1 for fall and December 1 for spring Application: Apply online at www.gedscholarship.org.

Arkansas Health Education Grant (ARHEG)

This grant provides financial assistance to students seeking professional training in chiropractic medicine, dentistry, optometry, osteopathic medicine, podiatric medicine, and veterinary medicine to allow them to attend out-of-state institutions. Complete the YOUniversal application at https://www.ark.org/adhe_financialaid/login.aspx.

Arkansas Governor’s Commission on People with Disabilities
This grant is awarded to disabled Arkansas residents. Applicants must be a full-time student unless disability prevents full-time attendance. Amount: $1000 Deadline to Apply: February 27
Application: Contact the Arkansas Rehabilitation Office at 501-296-1600

School Specific Scholarships

Pulaski Technical College

·  Ben Wyatt Scholarship

·  Frank White Rotary Club of Little Rock Scholarship and Rotary Club of Little Rock Scholarship

·  Harriet Frazer Scholarship

·  Simmons First National Bank Endowed Scholarship

·  Single Parent Scholarship Fund of Pulaski County (SPSF)

Apply for scholarships at: http://www.pulaskitech.edu/current_students/scholarships.asp
Southern Arkansas University

·  Presidential

·  University

·  Blue & Gold

·  Valedictorian/Salutatorian

·  Top 10%

·  Leadership Incentive Award

·  Achievement Award

·  Two-Year College

·  Non-Traditional Student

·  Art, Music, Theatre

·  Departmental
Apply for scholarships at: http://web.saumag.edu/admissions/apply/scholarships/

University of Central Arkansas

·  UCA Transfer

·  UCA Distinguished

·  UCA Excellence

·  UCA Achievement

·  UCA University

·  UCA Leadership

Apply for scholarships at: http://www.uca.edu/admissions/academicscholarships.php

University of Arkansas at Fayetteville

·  Chancellor’s

·  Chancellor’s Merit

·  Chancellor’s Community

·  Silas Hunt

·  Honors College Academy

·  Razorback Bridge

·  Leadership

·  Freshman Academic

Apply for scholarships at: http://www.uark.edu/rd_vcaa/schl/1239.php

Harvard University

Harvard announced that undergraduate students from low-income families will no longer pay tuition! If you know of a family earning less than $65,000 a year with an honor student graduating from high school soon, Harvard University wants to pay the tuition.

For more information visit: http://isites.harvard.edu/icb/icb.do?keyword=k51861&pageid=icb.page246751&pageContentId=icb.pagecontent485705&state=maximize or contact the school's financial aid office.

University of Phoenix

U of P is partnering with the National Foster Parent Association and will provide 50 full tuition scholarships for youth in foster care. For more information, visit: http://www.phoenix.edu/tuition_and_financial_options/scholarships/nfpa-scholarship.html.

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