Education Navigation Application

For Internal Use Only

Program Applying for:

Welcome

Welcome to the Education Navigation Mentorship Application! If you have any questions or issues while completing the application, please contact us at: navigationprogram@ccdofw.org

At the end of the application will be asked to upload PDF's of the following:

1. your Student ID, Driver’s License, or other proof of identification with a photograph

2. your most recent Transcript (College or High School)

3. your FAFSA Student Aid Report/SAR (available online

https://studentaid.gov/help/view-sar; please upload the entire report) or TASFA if you are not eligible for FASFA. *UNT/TWU Students are not required to upload a TASFA/FASFA.

If you do not have these documents, the system will allow you to submit the application, but your application will not be complete until you send in the required documents. You will receive an email requesting the missing documents with additional information once you complete the application.

Contact us at navigationprogram@ccdofw.org if you have any questions.

Will you be at least 18 years old by the start of the semester?

What is your highest level of education?

School Information

What college will you be attending?

Which Campus?

Are you dual-enrolled in high school? (Dual Credit)

Student ID

Referral Information

How did you hear about Education Navigation?

Name of College Faculty/Staff

Name of Student

If other specify

Personal Information

First Name

Middle Initial

Last Name

Date of Birth

Please enter a valid Date of Birth in the format (MM/DD/YYYY)

Gender

Street Address

City

City: is case sensitive and needs to be confirmed.

State

Postal/Zip Code

County

Country

Another race or ethnicity (specify here)

Telephone

Email Address

Preferred Language

Military Information

U.S. Military Status

Emergency Contact Information

Emergency Contact Name

Emergency Contact Phone

Emergency Contact Relationship

Employment Status

Type of Employment

Annual Family Income

$

Annual Family Income is the total sum of all sources of gross income received by all family members within the previous calendar year.

Number of Adults (18+) in Household

Number of Children (>18) in Household

Parent(s) Highest Level of Education

Which category best describes your household?

Are you a dependent of your parent(s) or guardian(s)?

A dependent would be a member of a household that is not an independent earner and would be filed as a dependent under someone else's taxes (typically by a parent or guardian).

List ALL degrees/certificates you are seeking at this institution

If you have attended some college, list all the schools you have attended.

Do you have a past due tuition balance at any college?

If yes, explain

Why is it important for you to continue your education? What is your motivation for doing so? (Please write complete sentences)

How do you think having a personal mentor will help you? (Please write complete sentences)

Required Documents

Please upload all required documents. If you do not choose an additional file, please click on the link that reads "Remove".

1. Upload your Student ID, Driver’s License, or other proof of identification with photograph

2. Upload your most recent Transcript (College or High School)

To upload additional transcripts, click "Add another response"

3. Upload your FAFSA Student Aid Report/SAR (available online; please upload the entire report) or TASFA. Not required for MSU, UNT & TWU students.

To upload additional financial aid documents, click "Add another response"

Communication Consent and Disclaimer

By submitting this application, I authorize Catholic Charities Fort Worth staff to contact me by mail, phone, e-mail, and/or text message (SMS) about this program. CCFW will not sell or distribute your information to third parties unless we ask your permission.

Yes, I authorize.No, I do not authorize.