"Youth Investment Award Application Form - Florida Juvenile Justice Foundation" - Florida

Youth Investment Award Application Form - Florida Juvenile Justice Foundation is a legal document that was released by the Florida Department of Juvenile Justice - a government authority operating within Florida.

Form Details:

  • Released on September 25, 2014;
  • The latest edition currently provided by the Florida Department of Juvenile Justice;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;

Download a fillable version of the form by clicking the link below or browse more documents and templates provided by the Florida Department of Juvenile Justice.

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Download "Youth Investment Award Application Form - Florida Juvenile Justice Foundation" - Florida

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Florida Juvenile Justice Foundation
Youth Investment Award Application
The Youth Investment Award is an initiative to assist youths ages 15-21, who are or were served by the Florida
Department of Juvenile Justice. Funding may be requested to assist with the next step essential to academic
achievement or workforce readiness which cannot be met through any other available resources and is essential
to the youth’s success.
Awards may contribute to tuition, equipment, supplies, transportation, education or employability assistance
(e.g., uniform, medical goods or services, bus passes, special tools) with funding paid directly to the vendor.
Applicants must complete this form, write an essay, and include demonstrated past initiative taken. Applications
are reviewed by a committee at a minimum of once a month. ONLY applications that are COMPLETE will be
forwarded to the committee for review. Notification of the application status and decision will be sent via mail
and email within 30 business days after committee review. If awarded, the youth will submit 4 quarterly progress
reports to the Foundation.
Date of Application: ________________________________
Youth’s Full Name:
Social Security #:
--
--
(LAST, FIRST MIDDLE NAME)
Does Youth Currently Live with Parent/Guardian?  Yes
 No
Date of Birth:
-
-
Parent/Legal Guardian:
(LAST, FIRST MIDDLE NAME)
Youth’s Home Mailing Address:
City:
State:
Zip Code:
Home Phone: (
)
Cell Phone: (
)
Email:
Address of Youth at time of application (if different from home):
 Yes
 No
Is the Youth Currently In School?
If yes, Name of School:
Current Grade:
GPA:
Anticipated Graduation Date: ______________
Requested Assistance (Select all that apply):
Academic Progress:
Testing Fee: $______
College/ Vocational Application Fee: $_______
College/ Vocational Tuition (including online classes) $_______
o (include acceptance letter)
Employability Progress:
Work Supplies/Equipment $_______
Other:
___________________________________
Transportation $_______
Drivers License Fee $ ________
Birth Certificate Fee $ ________
Total Amount of Funding Requested (please list each amount included i.e. Tuition/books): $ _________
__________________________________________________________________________________________
Florida Juvenile Justice Foundation
Youth Investment Award Application
The Youth Investment Award is an initiative to assist youths ages 15-21, who are or were served by the Florida
Department of Juvenile Justice. Funding may be requested to assist with the next step essential to academic
achievement or workforce readiness which cannot be met through any other available resources and is essential
to the youth’s success.
Awards may contribute to tuition, equipment, supplies, transportation, education or employability assistance
(e.g., uniform, medical goods or services, bus passes, special tools) with funding paid directly to the vendor.
Applicants must complete this form, write an essay, and include demonstrated past initiative taken. Applications
are reviewed by a committee at a minimum of once a month. ONLY applications that are COMPLETE will be
forwarded to the committee for review. Notification of the application status and decision will be sent via mail
and email within 30 business days after committee review. If awarded, the youth will submit 4 quarterly progress
reports to the Foundation.
Date of Application: ________________________________
Youth’s Full Name:
Social Security #:
--
--
(LAST, FIRST MIDDLE NAME)
Does Youth Currently Live with Parent/Guardian?  Yes
 No
Date of Birth:
-
-
Parent/Legal Guardian:
(LAST, FIRST MIDDLE NAME)
Youth’s Home Mailing Address:
City:
State:
Zip Code:
Home Phone: (
)
Cell Phone: (
)
Email:
Address of Youth at time of application (if different from home):
 Yes
 No
Is the Youth Currently In School?
If yes, Name of School:
Current Grade:
GPA:
Anticipated Graduation Date: ______________
Requested Assistance (Select all that apply):
Academic Progress:
Testing Fee: $______
College/ Vocational Application Fee: $_______
College/ Vocational Tuition (including online classes) $_______
o (include acceptance letter)
Employability Progress:
Work Supplies/Equipment $_______
Other:
___________________________________
Transportation $_______
Drivers License Fee $ ________
Birth Certificate Fee $ ________
Total Amount of Funding Requested (please list each amount included i.e. Tuition/books): $ _________
__________________________________________________________________________________________
Youth’s Name:
Youth Investment Award Application
Last, First, Middle
Youth Consent:
I,
, do hereby consent to the release of my name, social security number,
grades and school transcripts and other confidential information to the community college or other
institutions/officials requiring the information in order to administer the gift to be made on my behalf. This
information will be provided on the condition that it is kept confidential by the receiving parties. I agree to allow
the post-secondary educational institution or high school to release my grades and other institutional
information about my performance and progress. Further, I hereby agree to notify the Florida Juvenile Justice
Foundation of any physical or mailing address change or of any telephone or e-mail address change within five
(5) days of its occurrence.
Youth’s Signature:
Date:
Professional Advocate (e.g. Youth’s counselor, teacher, probation officer, etc.)
Home Circuit # _________ County: __________________
Name:
Phone Number: ____________________
Signature:
Email:
To Be Completed by youth or Nominator
Nominator’s Full Name:
Job Title:
Place of Employment:
Mailing Address:
City:
State:
Zip Code:
Work Phone: (
)
Ext.:
Cell Phone: (
)
E-mail:
@
Relationship to Applicant:
Please state the reason(s) you believe this youth should receive a scholarship or grant through the Florida
Juvenile Justice Foundation, Inc. Also, please identify the youth’s strength(s). (You may attach one additional
page if needed.) If the youth is nominating himself or herself, the essay provided will substitute for this section.
Youth’s Name:
Youth Investment Award Application
Last, First, Middle
REQUIREMENTS:
Attach a 100-word (minimum) essay written by the youth that describes the requested need and intended
1.
benefit of the award. The essay should explain the youth’s personal and career goals, and must include action
steps taken or will be taken by the youth that will accomplish academic achievement or workforce readiness.
2. Provide complete vendor information (i.e. Business, Organization, Service Provider, etc.). If more than one
vendor is required, please provide all contact information on a separate page.
Vendor Information:
Name: __________________________
Payable To: _____________________
Address: ________________________
Phone Number: __________________
Total Amount: $_________________
Due Date (if applicable):____________
3. Return all information to:
Florida Juvenile Justice Foundation, Inc.
Phone: (850) 717-2713
2737 Centerview Drive
FAX (850) 922-7998
Tallahassee, FL 32399-0400
Caroline.Ray@djj.state.fl.us
Caroline.Ray@djj.state.fl.us
Completed application with signatures
Essay (Minimum 100 Words)
Vendor Information
Quarterly Progress Report:
th
Each Quarterly Progress Report is due on or before the 10
October, January, April, and July.
Check the appropriate quarter for this report:
July – September
October – December
January – March
April – June
Describe your accomplishments toward the outcome of your personal and career goals specified in your
application during this quarter. Include any obstacles and successes. Describe your action plan for next quarter.
Updated: September 25, 2014
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