Application Overview: The IPFW Bridges to Education and Careers Program (Bridges) is a collection of college campus and community-based programs for students with intellectual disabilities in participating school districts and the surrounding area. Accepted students begin participation in the Bridges Program January, 2016. Although Bridges provides many forms of support to students, Bridges students are expected to have the capacity to be independent and unsupervised both on campus and getting to and from campus. Additionally, students must be capable of doing college level work. The program consists of three different course offerings. A student may elect to take one or more courses. The offerings currently available are: Transition Program This program is appropriate for students who wish to transition successfully from High School to College. It consists of a 12 week program three days a week. It focuses on three main areas. 1. Self-advocacy and communication 2. Technology skills 3. Improving basic academic success strategies. Culinary Arts Course This program will introduce students to culinary skills and food safety standards, helping them properly identify and use equipment, products and cooking methods. Personal Development Course This course is designed to encourage independence and development of life-skills to students as they transition from the home to independent living. The ultimate goal of Bridges is to increase opportunities and foster greater success for students who are transitioning to postsecondary education. Key concepts to keep in mind include the following: Collaboration with the student, family, and high school team about a student s interests, assets, and needs is a key component to preparation prior to campus participation. Students have far more flexibility in their day and calendar, which will differ from the high school schedule. Students are strongly encouraged to have cell phones for use in communicating with Bridges staff during the program day. Education and Employment are the primary emphasis of Bridges. Students must be committed to career preparation in many forms, including unpaid internships and community service. Last Updated 8/14/15 Page 1
Applicants must: Be at least 18 years of age by the first day of class. Have a documented intellectual disability and high school students must have an IEP in place. Be working toward or have obtained a Certificate of Completion or diploma from high school. Agree that this will be the last year of student services provided in high school or have completed high school. Have the capacity to be independent and unsupervised while on campus. Meet eligibility requirements for Indiana Vocational Rehabilitation Services (VRS). Have transportation or the ability to travel independently. Have a good attendance and disciplinary record during his/her high school education. Visit the Bridges Program and staff on the IPFW campus prior to program start at least one time via city bus or anticipated mode of transportation if accepted into the program. For questions or additional information contact the following: Suzanne Yuhasz, Bridges-Program Assistant Yuhaszs@IPFW.edu Phone: 260-481-6592 Eric Wagenfeld, Bridges-Transition Program Coordinator Wagenfee@ipfw.edu Phone: 260-481-6658 Dr. John Niser, Bridges-Culinary Program niserj@ipfw.edu Phone: 260-481-5496 Last Updated 8/14/15 Page 2
Application Instructions: It is recommended that the student, his/her teacher-of-record [TOR], and parents work collaboratively to complete this application form and send it to: Suzanne Yuhasz IPFW: Walb Union Room 113 2101 E. Coliseum Blvd. Fort Wayne, IN 46805 The following attachments must be included with the application: High School Transcript Current IEP or Summary of Performance Most recent Evaluation Report Relevant Assessment reports Disability Documentation Please be sure to maintain a copy of the application packet for your records. The student selection process for Bridges includes the following steps: (1) The Bridges Admissions Committee reviews the Bridges Student Application and attached documents. (2) The Bridges Program conducts admissions interview with the student and his/her parent(s)/guardian(s). Last Updated 8/14/15 Page 3
APPLICATION The following questions are to be answered by the student s teacher-of-record [TOR] with input from the high school team, student, parent, and other transition team members. For those who have completed high school, questions should be answered by the student and parent: Student Name: Birthdate: SS#: School District: Student s Address: Student/Parent Phone(s): Student s Living Arrangement [i.e., family home, group home, supported living]: Teacher-of-Record Name: High School: 1. What community-based outcomes are projected in this student s IEP? [Please address employment, community living, post-secondary education, community participation, recreation/leisure etc.] 2. What community-based work experiences [unpaid and paid] has the student had to date? [List work history of employers, locations, hours, pay, dates, level of support required or attach Student Resume that includes these details] 3. What community-based learning experiences has the student had to date? 4. What level of support does this student require when using public transportation? Can the student ride alone? Last Updated 8/14/15 Page 4
5. What level of support does this student generally need for daily activities? 1 2 3 4 5 LOW MEDIUM HIGH Please describe the nature of support required: 6. Describe the nature of this student s family involvement and participation. Does the parent/guardian attend case conferences? meetings? school functions? respond to phone call or other correspondence? 7. Are there any of the following considerations we need to be aware of for safety and support purposes? Please check those that apply and then describe how it relates to meeting the student s needs (be specific). Medical Issues: Safety Needs/Considerations: Behavioral Issues: Means of Communication: Assistive Technology: Last Updated 8/14/15 Page 5
8. Does this student have: [A] Medicaid (for health care)? Yes No [B] Private Health Insurance? Yes No [C] A Medicaid Waiver [i.e., DD, Autism, Support Services etc]? Yes Which one? No OR Is this student on a Medicaid waiver wait list (completed an application)? Yes Application date (if known): No [D] An open case with VR? Yes** VR Counselor is: No **If yes: Has student chosen his/her adult agency? Yes: Adult agency employment provider is: No [E] SSI? Yes [Please include a copy of the SSI Award letter] No [E] SSDI? Yes [Please include a copy of the SSDI Award letter] No 9. Why do you think this student would benefit from Bridges @ IPFW? 10. When is this student s scheduled date of high school completion [stated on Case Conference Report; per conversations with parents]? 11. Which class(es) is this student most interested in taking? Transitions Program Personal Development Culinary Arts Last Updated 8/14/15 Page 6
12. Required Attachments (NOTE: can be electronic attachments or hard copy): High School Transcript Current IEP or disability documentation Most recent Evaluation Report (if testing is more than 3 years old it is highly recommended to have this testing updated before submitting the student s application) Other (please list if provided) Student References Please list 2-3 references outside of the student s family we can contact for information. Name Title/Organization Address Phone/Email Name Title/Organization Address Phone/Email Name Title/Organization Address Phone/Email Student Applicant s Signature: Signature of Parent: Last Updated 8/14/15 Page 7