Together We Rise COVID-19 Rapid Response Referral Partner Application

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COVID-19 poses a special risk to students with experience in foster care transitioning to and through college in Washington State. The Together We Rise COVID-19 Rapid Response Fund will allow campus support programs and nonprofits to have access to flexible resources to address challenges presented by COVID-19 that could potentially threaten a foster youth’s ability to transition to and through college.

PLEASE READ THE FOLLOWING INFORMATION CAREFULLY BEFORE PROCEEDING:
- Participation in this fund is limited to programs based in Washington.
- This form should be used only by college campus foster youth support programs and non-profits that serve foster youth who are either enrolled in college or transitioning into college. If you are not one of these, please do not complete this form.
- This form is to apply to become an authorized referral source to the fund. DO NOT USE THIS FORM TO SUBMIT INDIVIDUAL STUDENT REFERRALS.
- Agencies should submit one form only. Please confirm before proceeding that no other representative from your agency has completed this form or intends to complete this form.
- Please review the Fund Protocols thoroughly before completing this form. These can be found at {insert link}.

In order to make referrals to the fund you must be a college campus foster youth support program, or non-profit that serves foster youth enrolled in college. Please indicate which type of organization you are. *

College campus foster youth support program

Non-profit that serves foster youth enrolled in college

Name of Agency or Program *

Contact person name *

Contact person email *

Contact person phone number *

County where your program is located (if program has sites in multiple counties, list all counties) *

Number of foster youth served by your program *

Please indicate that you understand and agree to the following *

All individuals referred must be current or former foster youth. My agency will verify eligibility prior to making each referral.

All individuals must be current college students or high school seniors transitioning into college. My agency/institution will verify eligibility prior to making each referral.

This fund is meant to be a fund of last resort. I will utilize all other options available for emergency support prior to making a referral.

This fund is meant to address immediate emergency needs only. I will only make referrals that meet this standard.

Required

If you are a non-profit organization, please describe below the types of services you provide and the populations that you serve. (Campus based programs do not need to provide this information and can indicate N/A) *

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