WYOMING DEPARTMENT ofFAMILY SERVICES

Educational Training Voucher (ETV) Scholarship Application and Requirements

The attached application must be completed and submitted in full to Stacey Dunlay. All items included on the provided check listmust be submitted with the application. If any required information or items are missing the applicant will not be eligible for funding until all items are received. Applications received after the due dates, noted below, will not be accepted.

Eligibility Requirements for ETV Funding

1)Youth are eligible for ETV if:

a) they meet one of the following criteria:

(1)Youth were in foster care or DFS custody for 12 months after his/her 14 year birthday;

(2)Youth were adopted or placed in guardianship from foster care on or after his/her 16 year birthday; or

(3)Youth have left care after his/her 18 year birthday; and

b)Youth has a high school diploma or GED; and

c)Youth attend at least half-time an accredited school that:

(1)Awards a Bachelor’s degree or not less than a two (2) year program that provides credit towards a degree;

(2)Provides no less than one (1) year of training towards gainful employment; and/or

(3)Is a vocational program which provides training for gainful employment and the employer has been in existence for at least two (2) years.

2)Youth must maintain a 2.0 Grade Point Average (GPA) or better to continue to receive ETV funds. Awards after the first semester will be based on the student’s GPA.

3)Eligibility ends at 23 years of age if the youth has received ETV funds prior to his/her 21 year birthday and receiving passing grades.

  • If student’s GPA is below 2.0 from high school, it is required that a letter of endorsement from a teacher, IL coordinator, college advisor, etc be included with the application.
  • If the student is already receiving ETV funds and student’s GPA falls below a 2.0, the student will no longer be eligible for funding until a GPA of 2.0 or higher is reached. *It is important to understand that although this scholarship requires a 2.0, the school may require you to have a higher GPA to graduate.
  • An expulsion from the student’s funded program will result in permanent loss of ETV funds.

Funding is determined by current college GPA. If the student is a first year, first semester student funding of $1000.00 is the maximum amount provided. After the completion of the first semester the funding amount will be determined with the following criteria;

GPA 4.0-3.5 : up to $2,500.00

GPA 3.5-3.0: up to $2,000.00

GPA 3.0-2.5: up to $1,750.00

GPA 2.5-2.0: up to $1,500.00

Please note, these amounts may decrease at any time, depending on the quantity of applicants. If the educational program does not follow a standard semester schedule funding will be calculated accordingly on individual program variables.

Deadlines for Applications

Fall Semester: July 1

Spring Semester: November 15

Summer Session: May 15

Summer Semester: Dependent upon funds available

Checklist

These items are required for an application to be complete. Applications will not be processed until all items are submitted. Applications received after the due date will not be accepted.

Letter of recommendation is required from Independent Living Coordinator (ILC), teacher, college advisor, or DFS worker if youth’s GPA is below 2.0. Letters of recommendation are always encouraged and appreciated even with a GPA above 2.0.

Completed Educational Training Voucher (ETV) Application

Personal Statement explain why you feel you should receive funds

Completed and signed ETV Budget Planner

Photocopy of cost estimates from college or program catalog

Full transcript from high school or college, whichever is most recent

Notification of College/Program Acceptance

Summary of Financial Aid Awards from Financial Aid Office

Photocopy of completed scholarship applications or confirmation. It is required that you complete at least 2 additional scholarships aside from the Hathaway Scholarship (if eligible) and Craig Thomas (if not eligible for Hathaway).

Copy of full FAFSA application

Signed release of information for proposed school and DFS and ILC

Picture of yourself

Date submitted to Stacey Dunlay: ______

Education and Training Voucher (ETV)Application

Applicant must complete all items. Please type or print neatly. Send to Stacey Dunlay, Department of Family Services, 2200 Capitol Avenue, Third Floor, Cheyenne WY 82002.

Applicant Name: ______Birth Date: ______Age:_____

Ethnicity:______Social Security #: ______Phone #: ______

Address: ______

StreetCityState Zip Code

E-Mail Address:______

Type of Application:

NewReapplication (Discontinued ETV in the past & now reapplying)

Renewal application

Last school term for which you received ETV funds:______

ETV Eligibility:

Number of years you were in out of home placement (i.e. DFS, TFC, Attention Homes, Casey, etc): ______

Date youth left placement: ______

Were you adopted from care after you turned 16?______Yes ______No

If Yes, date of adoption:______

Educational History

List the schools you have attended, beginning with high school

School / City, State / Dates / Degree / GPA

List all public and private scholarships, grants, loans or other financial aid you have applied for to date. Attach copies of your applications to this form.

Description / Date Applied
FAFSA (must be completed for this application)
Hathaway Scholarship ( must apply)
Craig Thomas Scholarship (must apply)

Post-Secondary Educational/Vocational Plans:

Dates to be covered by this award (maximum of 12 months): From: ______To: ______

School/Program Name: ______Phone #: ______

Address (including city, state & zip code): ______

______

School/Program Type (check one):PublicPrivate

Have you been officially accepted to this school/program? Yes No

Degree Goal: CertificateAA BABS

MastersDoctoralOther: ______

Field of Study: ______

Type of Term:QuarterSemesterOther: ______

Total Credits Required for Degree Goal: ______Credits earned to date:______

Anticipated Graduation Date: ______Terms completed to date: ______

Personal Statement

Describe your short-term educational or vocational plan and long-term career goals. Please respond to the following questions. As long as this information is conveyed with your application, you may use whatever media you choose, including videotape and audiotape. The text boxes will expand automatically as you type in them. You may use the text boxes or attach a separate answer sheet if you wish.

  1. What are you planning to study, and why?
  1. How will your chosen program plan support your career goals?
  1. Why did you choose this particular school or program?
  1. What supports will you need to be successful? (e.g., people, money, technology, tutor, mentor.)
  1. List awards, honors or scholarships you have received.

Award/Honor/Scholarship Received / Date
  1. List your extracurricular interests or hobbies from the past year and explain which interests you hope to pursue during this coming year?
  1. Describe special or personal achievements.
  1. How do you plan to contribute financially to your plan? What are your plans for employment and/or work-study during the school year and summer break?

ETV Budget Planner

A personalized budget must be established and attached to this application. The included template below should be used to assist in the development of your budget. Please work with your ILC regarding assistance in the development of this budget.

The completed budget should be signed by you, your ILC, and your DFS worker. * If you are no longer working with an ILC or DFS worker you may complete this budget plan independently or it’s recommended that you contact an ILC for support. If you need contact information for your local ILC please contact Stacey Dunlay for provider contact information.

Your budget shall include all personal income, external aid, and requested ETV contributions. In estimating expenses, total family costs and contributions must be declared (e.g., if your partner is paying for half of your rent you must disclose the total rent cost and indicate that half of the cost is paid for by your partner).

Sources of Income:
Savings
Employment
Other (describe)
Total

What external (grants, scholarships, WIA monies, loans) income will be paid to vendors and/or you?

Grants
Scholarships
WIA Monies
Loans
Totals
Expenses:
Education/Program-Related Expenses / Description (what, how much, when) / Monthly / Annual Total / Student Contribution / Unmet Need
Tuition & Fees
Books/Supplies and Tools
Computer/Required Equipment
Tutoring
Other
What are your living-related costs? / Description (what, how much, when) / Monthly / Annual Total / Student Contribution / Unmet Need
Room/Rent
Board/Food
Personal Expenses
Transportation
Clothing
Child Care
Other
What are your health-related costs? / Description (what, how much, when) / Monthly / Annual Total / Student Contribution / Unmet Need
Health Insurance
Therapy
Dental
Orthodontia
Medical Services
Prescriptions
Vision Care
Other
Totals:

Approved:

Student: ______

ILC Provider: ______DFS Worker:______

A violation of any of the following requirements will be the basis for being placed on probation. Flagrant violation may result in immediate revocation of your ETV funding.

  1. Youth must follow a program leading to specific job skills, diploma, degree, or certificate.
  2. Youth must attend school or program as outlined in the educational plan (full-time or part-time) as defined by the institution or program. Changes from full-time to part-time status must be reported to the Transitional Living Coordinator, Stacey Dunlay, immediately.
  3. Youth must maintain a level of academic standing necessary to be eligible for federal financial aid (2.0 GPA). If this is not an academic program, youth must meet the standards set forth by the program.
  4. Youth must maintain good academic, worksite and behavioral standing as defined by the institution.
  5. Youth must make real effort toward self-support whenever possible.
  6. Social Security and Veteran's Administration benefits, as well as earnings, must be applied toward educational expenses.
  7. Since it is important for the Transition Living Coordinator to be aware of student progress, youth will send grade transcripts or other performance reports to the Transition Living Coordinator as soon as the school prepares them. On occasion youth may be asked to send personal progress reports to the program.
  8. Youth must report immediately any changes in status such as leaving school, change of major, change of address, and other important changes affecting financial support.
  9. Youth must use Education and Training Voucher Program funds for the stated purpose described in the budget plan.

Applicant Approval:

Having read the above conditions regarding receipt of educational awards from the Department of Family Services and understanding their content, I indicate my intent to abide by the above conditions if I receive an award. I understand that additional requirements may be added during review of my application. I understand that failure to meet these requirements may result in withdrawal of the ETV educational award. I further indicate that the information reported in the above application is complete and accurate to the best of my knowledge.

Applicant Signature / Date

Steve Corsi, DirectorMatthew H. Mead, Governor