Fostering Success support funds application

PDX Bridge

Fostering Success support funds application

"*" indicates required fields

Facebook

This field is for validation purposes and should be left unchanged.

Student name*

51�� ID number*

51�� email*

Phone

Amount requested*

Briefly describe reason for request*

How would these funds impact your success as a 51�� student?*

What steps are you taking to improve your financial situation?*

Referred for assistance by faculty / staff (if applicable)?

Documentation*

Please upload documentation to support the amount you are requesting. For example: a tuition bill, signed note from landlord, screenshot showing cost of car repair, etc. Please be as specific as possible. If you have questions, contact allison.trowbridge@pcc.edu.

Drop files here or

Accepted file types: jpg, jpeg, jpe, png, gif, webp, pdf, vtt, Max. file size: 20 MB, Max. files: 3.

Foster status verification*

A staff member at 51�� (or partner agency) can verify that I was in foster care

I can upload paperwork or correspondence from DHS that shows I was in foster care

Please verify my foster care status directly with DHS (requires a signed Release of Information form)

Staff name*

Employer and job title*

Contact info (email / phone)*

Upload paperwork or correspondence from DHS showing you were in foster care*

Accepted file types: jpg, jpeg, jpe, png, gif, webp, pdf, vtt, Max. file size: 20 MB.

Release of Information form
Complete the . List 51�� as the entity to release information to and submit the form to DHS.

51����

Fostering Success support funds application

51��