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A Sense of Home Dorm Kit Application
This is a pilot program being launched by
A Sense of Home
. Please note that applicants are not guaranteed to receive dorm kits, as availability is contingent to ASOH receiving dorm kit donations. Items included in dorm kits granted to applicants may vary, again based on donations received by ASOH. Applying to receive a dorm kit by ASOH does not bar applicants from applying for Home Creations when they move in to their very own first home in the future.
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* Indicates required question
First Name
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Your answer
Last Name
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Your answer
Phone Number
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Your answer
Email Address
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Your answer
Confirm Email Address
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Your answer
Date Of Birth
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MM
/
DD
/
YYYY
Do You Identify As LGBTQ
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Yes
No
What Is Your Ethnicity
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African American
Asian/Pacific Islander
Caucasian
Hispanic
Mixed (non-Hispanic)
Other
Decline to State
Are you a former foster youth or currently in care?
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Yes
No - never been in foster care
What age were you placed in the foster care system?
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Your answer
Are you currently working with an agency that is supporting you with your educational goals? If yes, please list the name of the agency.
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Your answer
Please share the contact information of the agency/contact
you are currently working with that is supporting you with your educational goals?
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Your answer
What is/was your housing situation before moving into the dorm?
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Your answer
Have you ever experienced homelessness?
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Yes
No
What school are you attending?
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Your answer
Please provide your school address.
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Your answer
What is your major?
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Your answer
What is your ultimate educational goal?
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Your answer
What year are you in school?
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Freshman
Sophomore
Junior
Senior
Other:
Are you a transfer student?
If yes, please share where you transferred from?
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Your answer
Are you studying full time or part time?
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Full time
Part time
Are you currently working? If so, how many hours a week?
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Your answer
Where are you working?
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If you are not working enter "NA"
Your answer
When is/was your dorm move in date?
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MM
/
DD
/
YYYY
What is your dream career?
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Your answer
What are your favorite colors?
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Your answer
When you close your eyes to relax and just breathe, what do you see? For example, do you imagine a beach setting, or a creek, or a forest, or a lake, a river, or certain animals, or types of flowers? Please explain what soothes you.
Your answer
Who are some of your heroes/ sheroes?”
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Your answer
What Are Your Hobbies?
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Your answer
Do you need additional items for your dorm (mini fridge, printer, etc)?
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Your answer
How did you hear about ASOH?
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Your answer
How will a dorm kit from ASOH help advance your educational goals?
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Your answer
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