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Opportunity Grant Application Form
Full Name:
Birth Date:
Address:
City:
Zip:
Washington Resident:
Yes
No
--If yes, how Long?
Student ID#:
Home Phone:
Cell Phone:
Email:
Household monthly income:
Source of income:
Occupation:
Full Time
Part Time
If you are claiming zero income, how do you support your yourself:
Check if you are receiving:
TANF
Unemployment
VA or Military Benefits
Work First
GAU
BFET
L&I
Worker Retraining
SSI
Passport/Former Foster Care
Household size, including yourself:
List names, ages & relationships of those living in your home:
High school Graduate?
Yes
No
GED?
No
Yes
Have you applied for
financial aid (FAFSA)?
No
Yes
What program degree or
certificate are you pursing?
What is your transportation to Olympic College?
What is your back up plan?
What is your childcare plan?
What is your back up plan?
Do you need assistance paying for Child Care?
Yes
No
What is your housing situation?
Parents
Own/Rent
Homeless
Couch surfing
Have you received Opportunity Grant funding
at any other Washington State College?
No
Yes
--If so, what college?
Is Olympic College your first college experience?
Yes
No
--If no, list the College Name(s), Attendance Date(s), and Degree(s) or Certificate(s):
The funds available through the Opportunity Grant are highly competitive. Please read the following questions carefully and answer completely. If you need assistant or have concerns please contact the grant office.
What type of employment are you working towards?
Why have you chosen this education/employment pathway? What makes you excited about your future employment possibilities? Tell us about your goals; where do you see yourself working
Think about school, work, and family responsibilities. What does it take for you to be successful in college with the pressures of life and these responsibilities?
What challenges and barriers have you faced in college?
How have you overcome these challenges?
What or who is your support system as you attend college? Where or who do you turn to for help and support?
Write a brief essay to describe why you need this grant; 75—200 words or more.
Affidavit of Truth Statement:
The information provided on this form is, to the best of my knowledge, accurate and true.