Youthful Offender Scholarship Application

Texas Youthful Offender Scholarship Application
Are you completing this application on behalf of an incarcerated family member, friend, or loved one?*

YesNo
If Yes, what is your relationship to applicant?*
CONTACT INFORMATION:
Name (First, Last)*
Phone Number*
Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
APPLICANT INFORMATION:
Are you currently in the custody of the Texas Department of Criminal Justice?*

YesNo
Name*

First NameLast Name
TDCJ#*
Current Unit of Assignment*
Unit Address *
What trade certification are you seeking? *
Have you previously applied for the Youthful Offender Scholarship? *

YesNo
If yes, please provide the date

MonthDayYear
Date
Cost of trade certification you are seeking?*
Enter in Dollars & Cents, for example $100.00
Is this your first trade certification?*

YesNo
Were you certified in any trade or technical skill prior to entering the Texas Department of Criminal Justice?*

YesNo
Have you applied and been accepted into the program in which you are requesting the scholarship?*

YesNo
Anticipated Start Date*

MonthDayYear
Date
Are you a United States Citizen?*

YesNo
Currently the Youthful Offender Scholarship is available only to those born outside of the United States and do not have U.S. citizenship status.
Country of Birth*
Do you currently have an immigration detainer with U.S. Immigration and Customs Enforcement (ICE)? (You will be required to provide Proof of Detainer.)*

YesNoUnsure
If you answered "Unsure" to the previous question, have you or a loved one ever applied for citizenship on your behalf prior to incarceration?

YesNo
What was the outcome?
OFFENSE & SENTENCE INFORMATION:
The Nature of Your Offense Does Not Determine Your Scholarship Eligibility
The Youthful Offender Scholarship is not available to anyone over the age of 24 at THE TIME OF OFFENSE
Date of Offense*

MonthDayYear
Date
County of Offense*
Age at time of offense*
Length of sentence*
Time remaining on sentence*
Parole Eligibility Date? Please list N/A if not applicable*
Do you give permission to discuss your scholarship award/information with a party other than yourself?*

YesNo
If yes, please provide:
Name (First, Last)
Phone Number
Relationship
SIGNATURE:
Applicant Signature*

Clear
Date

MonthDayYear
Date
Please be sure to provide proof of detainer. If you are awarded a scholarship, an award letter with additional information will be mailed to you at the unit you have provided. Missing and/or incomplete documentation can delay or deny your scholarship request.

Scholarships are based on funding availability.

You may also download a copy and mail to your incarcerated loved one for completion. Please mail completed application to:
Freedom Granted Initiative Inc.
P.O. Box 420733
Houston, Texas 77242
Should be Empty:

Texas Youthful Offender Scholarship Application