• If this question does not apply to you, please respond with N/A.

  • WORKFORCE DEVELOPMENT-COLLEGE & CAREER PROGRAM APPLICATION

  • Location*

    • Section A: Demographic Information 
    • Date of Birth*
       - -
      2 digit month, 2 digit day, 4 digit year
    • Are you disabled?*
    • Are you a U.S. citizen?*
    • Gender*
    • Marital Status as of TODAY*
    • Are you a veteran?*
    • Are you military connected?*
    • If yes*
    • Ethnicity*

    • Employment Status*
    • Your highest grade level Completed as of the date of this application (Select only ONE)*
    • If currently in college, circle year completed*
    • Enrolled Date*
       - -
      2 digit month, 2 digit day, 4 digit year
    • Enrolled Date*
       - -
      2 digit month, 2 digit day, 4 digit year
    • Services you need (You may select more than one)*
    • Section B: Family Information 
    • Does anyone in your household receive free or reduced price lunch meals at school?*
    • Section C: Parent's Personal and Educational Information 
    • Did either of your parents complete a 4-year college degree?*
    • Applicant's biological father completed (check one)*
    • Applicant's biological mother completed (check one)*
    • Section D: Income Documentation 

    • Documentation of family income is REQUIRED in order to be considered for participation in any NACEE program

    • 2019 Taxable Income: Fill in the 2018 taxable income on the appropriate line. DO NOT use adjusted gross income for this report.*
      Rows
    • I am a free and reduced lunch recipient.*
    • Using the same amount, please check the appropriate family income range on the following scale. DO NOT use the adjusted gross income for this report.*
    • Section E: Untaxed Income 
    • If you did not file a tax return or if you receive any untaxed benefits, please list the amount shown on your 2019 "End of Year" statement(s) for all members of your family living in your household.*
      Rows
    • Income Status*
    • Termination date*
       - -
      2 digit month, 2 digit day, 4 digit year
    • Postsecondary placement*
    • College ready*
    • Section F: Client Signature 

    • All information shared with the North Alabama Center for Educational Excellence is strictly confidential and is used solely for determining client's eligibility for project participation. Additional proof of income or family benefits may be required.

      Office location and phone numbers:
      Decatur 256.350.6478 / Huntsville 256.372.4600 / Scottsboro 256.259.3072

      My signature below indicates, to the best of my knowledge, that the information provided on all forms of this application packet (IDS, IEP, and Contact Sheet) is true, complete, and accurate. I hereby authorize the North Alabama Center for Educational Excellence staff to obtain copies of my or my child's academic and financial assistance records from the educational institution (I) he/she is now attending and from educational institutions (I) he/she will attend in the future.

    • Date*
       - -
      2 digit month, 2 digit day, 4 digit year
    • Date*
       - -
      2 digit month, 2 digit day, 4 digit year
    • Individual Education Plan (IEP) 
    • Check the level of education you want to achieve*
    • Information on Schools / Colleges*

    • Financial Aid Information*

    • Career Planning*

    • Tutoring and Academic Support*

    • Date*
       - -
      2 digit month, 2 digit day, 4 digit year
    • Submit 
    • Should be Empty: