GV BOCES LIVES student application packet updated may 2011

SM The L.I.V.E.S Program (Learning Independence, Vocation, and Education Skills) at SUNY-Geneseo, in collaboration with Genesee Valley Educational Partnership Student Application Please return application to both addresses listed below: Elizabeth W Hall, Ph.D SUNY-Geneseo The L.I.V.E.S ProgramSM College Circle 220B South Hall Geneseo, NY 14454 Charles DiPasquale Genesee Valley Educational Partnership 80 Munson Street LeRoy, NY 14482 The L.I.V.E.S ProgramSM is collaborative program funded by SUNY-Geneseo and the Genesee Valley Educational Partnership Enrollment is limited Updated May 2011 The L.I.V.E.S ProgramSM at SUNY-Geneseo in collaboration with Genesee Valley Educational Partnership, Requirements Application Process While the L.I.V.E.S Program is a university-based transition program, students will be admitted to the G.V Educational Partnership (GVEP) 18-21 year old L.I.V.E.S ProgramSM at SUNY-Geneseo and not SUNY-Geneseo Students in this program will not be matriculated students of SUNY-Geneseo The L.I.V.E.S ProgramSM will seek to accept - 12 new students each year, typically between 18-21 years of age at the start of their program All applicants must complete an application process Potential applicants may be observed by a L.I.V.E.S ProgramSM and GVEP staff member a minimum of two times to help determine appropriateness of the program for the student Potential applicants will likely:  have intellectual and/or developmental disabilities;  comprehend at a third grade reading level;  be able to communicate, or with a communication device, with others;  have attended years of high school and have maintained a satisfactory attendance record;  be working toward the Common Core Standards as deemed by NY State Regents, IEP diploma, or certificate;  have demonstrated successful participation in an academic setting, function-skills curriculum, and in a vocational situation;  demonstrate good social skills and the ability to act in socially appropriate manner;  have demonstrated independence and social skills, and a desire for greater independence and further development of social skills;  have a familial or natural support group that will help the student to reach his/her goals;  travel independently or be instructed to use the LATS public transportation system; have a familial or natural support group to provide transportation to and from the college setting and other events as determined by the student, that are not provided by the LATS bus system; and  be willing to make a four-year commitment Applications are due by April 15th for the following academic year Once the complete application has been submitted, potential applicants will be contacted the middle to end of May for a mandatory student interview and parent/family interview The following documentation should be included along with the application:  Most recent Individualized Education Program Plan (IEP);  Most recent Educational and Psychological Evaluations (within years);  Related Services Assessments if applicable (Speech, PT, OT, Assistive Technology, etc); and  Teacher or service provider letter of recommendation Updated May 2011 Admission decisions will be made by June 15th for students beginning in the fall semester Decisions are based on:  Applicant's learning needs and desire to attend program;  Ability of program to meet applicant's needs and goals;  Ability of the applicant to exhibit appropriate behavior and independently negotiate transitions between classes, buildings, lunch, and non-academic activities;  Potential of applicant to successfully achieve his/her goals within the context of the program content and setting; and  Commitment from the applicant's family/caregivers to support the goals of the program All applicants and their families must participate in an interview process which is designed to determine the student’s needs, preferences, and interests; taking into account his/her specific wants and desires The interview process is designed to determine:  The applicant’s learning preferences;  Current life skills;  Vocational interests; and  Independence levels Updated May 2011 Materials to Include in the Application Packet The SUNY-Geneseo/GVEP L.I.V.E.S ProgramSM Application Questions about Me Parent/Guardian Information (recommended but optional – to be completed by the parent/guardian) Three (3) letters of recommendation (see enclosed forms) a One letter must be from the current School District’s CSE Chairperson b One letter should be from a teacher (general education, special education, vocation, humanities, etc.) c One letter could be from an employer or community member d One letter could be from a relative or friend Acknowledge of Responsibility and Student Release of Information Agreement Emergency Contact/Medical Information form High School Transcript Copy of last Individualized Educational Program Educational, Psychological, and Social Evaluations conducted within the last three years 10 Recent photograph Mail Completed Application to both addresses below: SUNY-Geneseo L.I.V.E.S ProgramSM c/o Elizabeth W Hall, Ph.D., PRSE College Circle 220B South Hall Geneseo, NY 14454 Charles DiPasquale 80 Munson Street LeRoy, NY 14482 You will receive a letter to confirm that your application has been received Please DO NOT call about the status of your application, as we will not provide that information over the telephone We will call students to schedule an interview in the order in which the applications were received If you have any questions about completing the application, please contact Dr Elizabeth W Hall at 585-245-5351 or Mr Charles DiPasquale at 585-344-7552 Updated May 2011 The L.I.V.E.S ProgramSM Application Form SUNY-Geneseo/Genesee Valley Educational Partnership for students ages 18-21 This form is to be completed by the student Name Address City State Zip Code Month Year Alternate Phone number Date of Birth Month Day Year High School Attending or Attended Date of Graduation or Expected Graduation I understand that I am applying to a 4-year program for transition, vocational/employment, and educational skills at SUNY-Geneseo, funded through a collaborative partnership by SUNY-Geneseo and Genesee Valley Educational Partnership The information provided on this application is my own work and represents my own thoughts I verify that I meet the eligibility requirements as described on page of this packet Your signature Print your name Date Updated May 2011 The L.I.V.E.S ProgramSM Application Form SUNY-Geneseo/Genesee Valley Educational Partnership for students ages 18-21 Questions about Me Name Please answer the following questions to the best of your ability Your answers should be short, but you may attach additional sheets of paper if needed Tell us about any activities, hobbies, and/or groups that you belong to or have belonged to (You may not have an answer for each question) I play the following sports I belong to the following clubs or organizations or I have belonged to the following clubs or organizations I work at My other interests include I would like to take a class or classes about Updated May 2011 Two goals for my future are a Goal b Goal Updated May 2011 The L.I.V.E.S ProgramSM Application Form SUNY-Geneseo/Genesee Valley Educational Partnership for students ages 18-21 Parent/Guardian Form (recommended, but optional) Name Address Phone number Alternate Phone number Email address Relationship to the student Student’s Name Please discuss why you are interested in the L.I.V.E.S ProgramSM for the applicant Please discuss any assistance the applicant had in completing this application (This will not affect the admissions decision process.) I understand that is applying for admission to attend the L.I.V.E.S Program, a transition/postsecondary program, at SUNY-Geneseo in collaboration with Genesee Valley Educational Partnership If s/he is selected to participate, I will ensure that s/he will attend the program I certify that s/he meets the following eligibility criteria: has an intellectual or developmental disability; is between the ages of 18 – 21; demonstrates a desire to continue his/her education; and displays socially appropriate behavioral and social skills in the school, home, and community Signature Print your name Date Updated May 2011 The L.I.V.E.S ProgramSM Application Form SUNY-Geneseo/Genesee Valley Educational Partnership for students ages 18-21 Personal Recommendation Letter About the Applicant Applicant’s Name Applicant’s Address About the person writing the recommendation Name Address Phone number Alternate phone number Email address Relationship to the applicant I have known the applicant for (specify years/months) Please use a separate sheet of paper to discuss the following: Describe your relationship with the applicant Describe why you feel the applicant would benefit from a transition (vocational/employment and education) program at a postsecondary institution Describe the applicant’s desire to learn, using examples from your relationship These letters should be no more than two (2) pages in length Please sign your letter, seal the letter in an envelope and sign across the seal Return the letter to the applicant, who must enclose it in his/her application packet Admission to the L.I.V.E.S ProgramSM is offered on a rolling basis Applications will be accepted starting April 15th, annually and continue until the program is full The SUNYGeneseo/G.V E.P L.I.V.E.S ProgramSM anticipates admitting – 12 students every fall Updated May 2011 The L.I.V.E.S ProgramSM Application Form SUNY-Geneseo/Genesee Valley Educational Partnership for students ages 18-21 Acknowledgement of Responsibility and Student Release of Information Agreement By signing this agreement, and by participating in the L.I.V.E.S ProgramSM, I acknowledge that SUNYGeneseo and Genesee Valley Educational Partnership will be collecting information and data about my personal and academic achievements through this program I understand that this information will be used to encourage my development, as well as to help improve the services provided by the L.I.V.E.S ProgramSM I understand that information gathered about me may be used in reporting back to SUNY-Geneseo and Genesee Valley Educational Partnership (funding agencies) I understand that my name and image may appear in reporting documents and on the L.I.V.E.S ProgramSM webpage I give SUNY-Geneseo and Genesee Valley Educational Partnership the right to use my photograph, quotes, and/or video tapes of me for public relations and/or training purposes At all times, SUNY-Geneseo, Genesee Valley Educational Partnership, and its agents, will to the greatest extent possible, protect my privacy and confidentiality Name Signature Date Updated May 2011 The L.I.V.E.S ProgramSM Application Form SUNY-Geneseo/Genesee Valley Educational Partnership for students ages 18-21 Sample Student Interview Questions Students who submit a completed application form will be required to participate in an intake interview with members of the L.I.V.E.S ProgramSM Admissions Committee This interview will provide the student the opportunity to learn more about the program and give the Admissions Committee the opportunity to learn more about the student The questions below illustrate the types of questions that may be asked during the intake interview; there are no right or wrong answers to the questions and students not need to prepare or rehearse answers to these questions Why you want to go to college? What you know about SUNY-Geneseo and the L.I.V.E.S ProgramSM? How will you get to and from college? What questions to you have about the L.I.V.E.S ProgramSM and school? Updated May 2011 The L.I.V.E.S ProgramSM Application Checklist SUNY-Geneseo/Genesee Valley Educational Partnership for students ages 18-21   I attended an informational meeting on SM I completed and submitted an application to the L.I.V.E.S Program at SUNY-Geneseo, in collaboration with Genesee Valley Educational Partnership, to Dr Hall and Mr DiPasquale  I submitted my high school transcript and any postsecondary records  I submitted current educational, psychological, and social evaluations which have been conducted within the last two (3) years (an IEP is not considered an evaluation)  I completed the L.I.V.E.S ProgramSM application packet, which includes: o L.I.V.E.S ProgramSM application o Questions about Me o Parent/Guardian Information (recommended but not required) o Three letters of recommendation  Letter from CSE Chairperson (mandatory)  Teacher  Employer/Community Member  Personal (relative) o Acknowledgement of Responsibility and Student Release of Information Agreement If the student is accepted into the L.I.V.E.S ProgramSM the student will need to provide a recent photograph, medical information, sign and follow the SUNY-Geneseo Student Code of Conduct Updated May 2011 ... classes about Updated May 2011 Two goals for my future are a Goal b Goal Updated May 2011 The L.I.V.E.S ProgramSM Application Form SUNY-Geneseo/Genesee Valley Educational Partnership for students... Vocational interests; and  Independence levels Updated May 2011 Materials to Include in the Application Packet The SUNY-Geneseo/GVEP L.I.V.E.S ProgramSM Application Questions about Me Parent/Guardian... Signature Date Updated May 2011 The L.I.V.E.S ProgramSM Application Form SUNY-Geneseo/Genesee Valley Educational Partnership for students ages 18-21 Sample Student Interview Questions Students who