Project SEARCH New Student Application

Transcription

1 Project SEARCH New Student Application Student s Name School Site Preference (please list first, second, third, fourth choice) Rosen Shingle Creek Resort Florida Hospital Winter Park Memorial Florida Hospital East Orlando Florida Hospital Orlando

2 Project SEARCH Application Purpose and Guidelines The purpose of this application packet is to determine if the student would be a good candidate for Project SEARCH. This application enables the Selection Committee to properly assess each student candidate s skills, abilities and background. A parent, student, counselor, teacher or employer may be contacted by the Selection Committee to gather additional information. The ultimate goal is to select students who will be successful in a Project SEARCH program and reach the outcome of competitive employment. The selection process includes the following guidelines: 1. All students are encouraged to attend an open house and must visit the host business site to observe the culture, possible rotations and meet the instructor and job coaches prior to being selected to participate in Project SEARCH. 2. A completed application must be submitted as soon as possible to the affiliated school s staffing specialist. Forms can also be submitted to: Bonnie Segal OCPS/ESE Transition Support Educational Leadership Center 445 W. Amelia Street Orlando, Fl x2671 Fax : bonnie.segal@ocps.net 3. The Selection Committee will review the applications and, if accepted, match the student s skill set and interests with the appropriate Project SEARCH program. 4. If accepted, an IEP will be developed with the IEP team for the school year. 5. If accepted, the student must be able to pass a criminal background check and drug screen. ** Please Note: Eligible candidates for Project SEARCH are h igh school students ages from Orange County Public Schools that have completed all of the necessary credit requirements for graduation with a Special Diploma. The Selection Committee will include representatives from Quest, representatives from the host business, representatives from Orange County Public Schools, a VR counselor and other persons as necessary.

3 Project SEARCH Entrance Criteria All participants of QuestWorks Project SEARCH program must agree to the following: Desire and plan to work competitively in the community at the conclusion of the Project SEARCH program Have a copy of the student s current Transition IEP and most recent Reevaluation paperwork Be at least 18 years of age Have completed the high school credits necessary for graduation with a Special Diploma. Meet eligibility requirements for Vocational Rehabilitation Apply to APD and other service providers as necessary for follow along services Have independent personal hygiene and grooming skills Have independent daily living skills Maintain appropriate behavior and social skills in the workplace Be able to communicate effectively Utilize public transportation when available and participate in travel training to ensure success in using the bus independently Have previous experience in a work environment (including school, volunteering and/or paid work) Additionally, for Rosen Shingle Creek Resort site only: Have the ability to successfully pass a drug screen and background check Be tobacco/smoke free Additionally, for Florida Hospital sites only: Have the ability to successfully pass a drug screen and background check Have immunizations up to date Complete a physical assessment

4 Project SEARCH Application Packet Checklist Please Note: All the required documents must be completed and sent together for application to be considered. o VR referral completed (Parent Completes) o Completed Staffing Specialist Form o Shot/Immunization Record or Copy o Current Individual Education Plan (IEP) including Transition Goals o Copy of most recent Reevaluation paperwork (All 3 year reevaluations that are due must be completed) o Current Multi-Factored Evaluation (MFE) Team Report* *Include the student s most recent math and reading scores/grade levels o High School Transcript o Most Recent Report Card o School Transcript From Any Other Formal Training (if applicable) o Attendance Record o Behavior Implementation Plan (last two years if applicable) **The Career Placement teachers can assist in collecting the High School Transcript, report card, shot records, copy of IEP and reevaluation, MFE (or most recent math and reading scores/levels), and Behavior Implementation Plan (if applicable). Completed packets should be submitted to: Bonnie Segal OCPS/ESE Transition Instructional Support Educational Leadership Center 445 W. Amelia Street Orlando Fl x2671 Fax: bonnie.segal@ocps.net

5 Personal Data Student s Full Name Last First Middle Student ID# DOB Gender: Male Female Address Street Address City State Zip Code District of Residence Phone Current School Parent/Guardian Name Last First Middle Address Street Address City State Zip Code Home Phone Work Phone Cell Phone Parent and Student Information 1. A student cannot graduate from high school unless all requirements of the affiliated school are met. 2. Final placement into this career major will depend upon the Individual Education Plan (IEP) meeting where applicable. 3. Student records concerning the applicant may be transferred to Quest from his/her affiliated school for review. 4. Career placement will be made without regard to race, color, national origin, sex, age, religion or presence of a disability. A two-week trial period will be required of all accepted enrollees. By signing below, the parent and student agree to comply with this procedure. Parent/Guardian Signature Date Student Signature Date

6 Employment Background How do you want to be employed in the community upon completion of Project SEARCH? Full time Part time Which shift would you prefer working after graduating from Project SEARCH? 1st Shift 2nd Shift 3rd Shift Do you plan to work during the school year, in addition to being in the Project SEARCH Program? Yes No If yes, where? How many hours/days? List jobs you do or have done in the past in school or in the community: Job 1 Job 2 Job 3 Employer Job Title Job Duties Supervisor Name Contact Number Paid or Unpaid? Have you ever been fired from a job? Yes No If yes, please explain: Have you ever quit a job? Yes No If yes, please explain: Transportation How do you plan to get to Project SEARCH? Bus Access Lynx Parents/Guardians Drive Self

7 Service Agencies Do you attend a Vocational Rehabilitation center? Yes No If yes: Counselor Name Phone Have you completed an APD (Agency for Persons with Disabilities) application? Yes No Do you have a Waiver Support Coordinator? Yes No If yes: Coordinator Name Phone Independent Living List all medications taken routinely. Use an additional sheet if necessary. Medication Dosage Time of Day Taken List any health or medical issues that may impact a successful job placement: Please list any limitations that impact employment: Behavioral Summary Do you have any behaviors that might impact a successful job placement? Yes No If yes, please explain:

8 Student Response Question Why do you want to come to Project SEARCH? Complete in your own words. References List three references (non-relatives): Full Name Relation to You Phone Authorization This application has been completed by: Printed Name Title Phone Number Signature Date Completed applications must be submitted as soon as possible to: Bonnie Segal OCPS/ESE Transition Instructional Support Educational Leadership Center 445 W. Amelia Street Orlando Fl x2671 Fax:

9 Staffing Specialist Form for Project SEARCH The section below must be completed by an authorized staffing specialist at the applicant's affiliated school and submitted with the completed application packet. A transcript and recent report card should be attached. Student s Name Total Credits to Date Staffing Specialist s Name Cumulative GPA Does this student have the necessary credits for graduation with a Special Diploma? Yes Date No List Course Deficiencies: Days Absent: 11th Grade 12th Grade Comments about Attendance: Other Comments: Staffing Specialist Signature Date FOR OFFICE USE ONLY: Date Received: Phase: AC CAC WL Comments: Plan Approved By: Student Number: QuestWorks l Project SEARCH l P.O. Box l Orlando, FL 32853