The Academy at Tommy Nobis Center Participant Application

  • The Academy at Tommy Nobis Center Participant Application

  • Application for Admission Procedure

    Congratulations on your decision to apply to The Academy at Tommy Nobis Center. We are delighted that you are applying and looking forward to reviewing your application for admissions.  

    The Academy at Tommy Nobis Center is an Accelerated Vocational Training Program for highly motivated young adults who have a diagnosed disability. To determine eligibility for The Academy we require an application packet to be completed for every person applying for services.  A sample application can be found on our website at:  Sample Application

     

    Criteria has been identified to best serve participants within the Academy. Each applicant is expected to demonstrate the following minimal requirements:

    □   A young adult with a disability

    □   Ability to function independently for extended periods of time

    □   Personal behavioral and emotional control

    □   Desire and motivation to obtain employment

    □   Must be willing to self-pay tuition and/or engage with alternative financial support options

    If you have any questions, please contact us via phone at 770-427-9000 or by email at TheAcademy@TommyNobisCenter.org, and we would be happy to help.

  • APPLICATION CHECKLIST

  • As you complete each section of the application, you will have the opportunity to continue or save your progress.  

    If the save button is selected, you will receive an email with a link to pick up where you left off.

  • □ Application

    □   Applicant Information

    □   Educational History

    □   Applicant Questionnaire (To be answered by applicant)

    □   Employment History (Attached resume, if applicable)

    □   Personal Support Inventory (To be completed by parent/guardian, if applicable)

    □   Names and contact information of recommendations

    □   Consent and signatures

    □   Official High School Transcripts, including:

    □   Last IEP and any post-secondary program record including summary of performance, OR

    □   Educational Evaluations conducted within the last 3 years, OR

    □   Most recent Psychological/Behavioral Evaluation

    □   Three completed Recommendations by those who have known the applicant 1 year or longer representing the following: educational, vocational/employment, and/or personal

    □   Proof and acknowledgement of Guardianship signature page and document, if applicable

     

    Note: Not all applicants who complete the application will be accepted into The Academy. A decision for selection will be based on the review of information in the application, personal recommendations, and the completion of an in-person assessment.

    Tommy Nobis Center reserves the right to contact the applicant, parent/guardian, and/or personal recommendations for additional information, if necessary, during the review of the application.             

  • APPLICANT INFORMATION

  • APPLICANT CONTACT INFORMATION

  • *Required

  • Format: (000) 000-0000.
  • Format: (000) 000-0000.

  • PARENT/GUARDIAN CONTACT INFORMATION -OR-SECONDARY POINT OF CONTACT (if living independently)

    *Required
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.

  • EMERGENCY CONTACT INFORMATION

    *Required
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.

  • EDUCATIONAL HISTORY

    *Required
  • Rows

  • Please allow the applicant to answer the following questions with minimal assistance:

  • APPLICANT QUESTIONNAIRE

    *Required

  • Please allow the applicant to answer the following questions with minimal assistance:

  • EMPLOYMENT HISTORY

    *Required     

    Please complete the following, including paid/unpaid employment, school-based employment training, and internships.

    Employment experience is NOT a requirement for admission.

  • PAST EMPLOYMENT

  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.

  • PERSONAL SUPPORT INVENTORY

    To be completed by parent/guardian/support person (or by applicant if living independently)

    *Required

  • Please fill in the information below as completely and honestly as possible. This information gives a greater understanding of the applicant’s support needs and is not a determining factor in acceptance to the program. Check all boxes that apply.

  • INDEPENDENT LIVING SKILLS

  • SOCIAL SKILLS AND COMMUNICATION

  • ACADEMIC SKILLS

  • Approximate reading grade level: *
    Title of the last book read: *

  • RECOMMENDATIONS AND RELEASE

    *Required
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.

  • Please upload the following below:

    1.  Official High School Transcripts

    • Last IEP and any post-secondary program record including a summary of performance
    • Educational Evaluations conducted within the last 3 years -OR-
    • Most recent Psychological/Behavioral Evaluation

    2. Proof and Acknowledgement of Guardianship signature page and document, if applicable

    3. Resumé, if applicable

    4. Any additional information related to academics, social skills, independent functioning, and employment readiness

     

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  • CONSENT

    The Academy at Tommy Nobis Center serves young adults with documented disabilities through an accelerated vocational training program. Throughout the 12-month program, each participant is expected to engage in Academy classes, an internship, and employment support experiences. Only individuals with a documented disability and commitment to meaningful work should pursue The Academy as a vocational program option.

    By signing below, you certify that all the information provided is true, complete, and correct to the best of your ability, and you are willfully applying to The Academy at Tommy Nobis Center with the intent to participate in the program if accepted.

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