Comprehensive Transition and Postsecondary (CTP) Program Interest Form

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A CTP is an educational initiative designed to support students with exceptionalities as they transition from high school to post-secondary education, employment, and independent living. Our program aims to provide a holistic approach to assist students in acquiring the skills, knowledge, and resources needed to successfully navigate the transition to adulthood. The ultimate goal is to empower students to achieve their educational, vocational, and personal aspirations and promote their full participation in society as independent and productive individuals.

Email *

First Name *

Middle Name (If you have no middle name put "N/A" *

Last Name (add any suffix) *

Gender (at birth) *

Female

Male

Social Security Number *

Date of Birth (mm/dd/yyyy) *

Ethnicity: ( Select One) *

African American

White

Asian

Native American

Hispanic

Other:

Please select Exceptionality or Disability (if more than one select all that apply.) The Comprehensive Transition and Postsecondary Program are designed to support students with intellectual disabilities who want to continue academic, career, and independent living instruction to prepare for gainful employment. *

Autism/ Autism Spectrum Disability (ASD)

Intellectual and Developmental Disability (IDD)

Cerebral Palsy

Down Syndrome

Mental Health Disorder

Other:

Required

Current Mailing Address: (City, State, and Zip Code) *

Permanent Mailing Address: ( City, State, and Zip Code) *if different from above

Primary Phone Number *

Cell Phone Number *

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