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Workforce Funding and Support Programs Application

PERSONAL INFORMATION SECTION: For questions/items that do not apply to you please write N/A in that field.

Date of Birth:(Required)
Mailing Address:(Required)
Are you currently receiving services from any of the following?:(Required)
Please select all that apply
Persons in Household 200% Poverty Guidelines Annual 200% Poverty Guidelines Monthly
1 $25,760 $2,147
2 $34,840 $2,903
3 $43,920 $3,660
4 $53,000 $4,417
5 $62,080 $5,173
6 $71,160 $5,930
7 $80,240 $6,687
8 $89,320 $7,443
Add for each person over 8 people: $9,080 $756

Education Information: For questions/items that do not apply to you please write N/A in that field.

Estimated Program Completion Date?:(Required)
This is your best guess based on the length of your program.

Employment Information: For questions/items that do not apply to you please write N/A in that field.

Financial Assistance Information: For questions/items that do not apply to you please write N/A in that field.

Which of the following is most likely to prevent you from being successful at school: Please check all that apply:(Required)
Please Select All That Apply:

Additional Information: For questions/items that do not apply to you please write N/A in that field.

PLEASE READ THIS SECTION CAREFULLY:
Please Select All That Apply to You.
Ability To Benefit:
ATB is for students who have not completed a High School credential (GED or Diploma) but would like to have access to financial aid and are academically ready to take non-high school classes. In addition to participating in an eligible career pathway program, students can become eligible for ATB by passing an approved test or successfully completing six college level credits. ATB allows a student to work on completing high school while receiving financial aid and moving forward on a career path.
GHC staff adheres to Family Educational Rights and Privacy Act (FERPA) regulations regarding the privacy of student information. The information you give us is confidential. Your signature certifies that the information you provided is to the best of your knowledge. It also authorizes GHC staff to share information.
Date(Required)
Consent to Virtual Signature(Required)

Continuous Non-Discrimination Notice

Grays Harbor College does not discriminate on the basis of race, color, national origin, sex, disability, sexual orientation, creed, religion, marital status, veteran status, genetics, or age in its programs, activities, and employment. The following person has been designated to handle inquiries regarding the non-discrimination policies: Title II/Section 504 Coordinator Darin Jones, Chief Executive of Human Resources Grays Harbor College 1620 Edward P. Smith Drive Aberdeen, WA 98520 360-538-4234 Title IX Coordinator Dr. Kari Collen, Dean of Student Access and Success Grays Harbor College 1620 Edward P. Smith Drive Aberdeen, WA 98520 360-538-4121
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