Scholarship Request Extension
Criminal Justice clients MAY be awarded a two week scholarship upon intake. Additional scholarship funding MUST be requested within the first 30 days of a residents stay. Eligibility is based on the residents compliance with the Life Changes rules and expectations. This funding is limited and is to be accessed for residents that are serious about changing their lives, who may have a delay in receiving a paycheck from their employer or who have a viable reason for needing additional assistance. Scholarship funding is extremely limited and expires in January 2022.
Client Name
*
First Name
Last Name
Intake Date
-
Month
-
Day
Year
Date
Has client received prior scholarship?
Yes
No
Is client employed?
Yes
No
Not medically cleared to work
Is client attending... (check for all YES answers)
Recovery/Self Help Meetings
Spiritual Services
Counseling
Is client complying with... (check for all YES answers)
Curfew
Chores
Remaining clean/sober
Work Search
Other program rules
Has client made any payments toward his service fees since intake?
Yes
No
Do you recommend client for an additional ONE WEEK scholarship?
Yes
Yes
Why do you feel this resident would benefit from an additional scholarship?
Today's Date
-
Month
-
Day
Year
Date
House Manager
First Name
Last Name
Submit
Should be Empty: