Generating Opportunities through Advocacy and Learning that Promote Success (GOALS)

Generating Opportunities through Advocacy and Learning that Promote Success (GOALS)

PROGRAM APPLICATION
Who is completing this form?*
Email of Person Completing this Form*
example@example.com
Name of Person Completing this Form*

First NameLast Name
How did you hear about the GOALS Program?*

Parent/Guardian Contact Information
Yes, the student is under 18 years oldNo, the student is 18 years or older
NOTE: If the participant is a minor, at least one parent/guardian MUST be listed below. The parent/guardian will be required to grant consent prior to the participant/student being able to participate in the GOALS program. No appointments will be scheduled until consent is received.

Consent forms are emailed after we receive a completed application.
First Parent/Guardian

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Second Parent/Guardian

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.

About the GOALS Program
Generating Opportunities through Advocacy and Learning that Promote Success (GOALS) is an initiative of Quality Services for the Autism Community (QSAC) that seeks to address the gap in services and support experienced by youth with autism and other intellectual/developmental disabilities who are preparing to transition from high school to life after high school. The program is open to students between 16 and 26 years old.

Space is limited for this program. Once you submit your application, you will be scheduled for an intake appointment to meet with a GOALS Advisor. Your advisor will help you determine services and support that you may be eligible for to support your employment goals. They will assist you with accessing these services and make referrals as needed.

The questions below will review the program participation requirements to ensure that this program is a good fit for you.

The program provides participants with the following support and services:
- Career Skills Workshops
- Training on Self-Advocacy and Self-Determination Skills
- Internship Opportunities
- Work-Based Learning Experiences
- Career and Life Coaching
GOALS Advisors can assist students with transition planning and linkage to service(s) as appropriate.
I understand that students must participate in a series of skill-building workshops that will be offered over the course of their first year in the program. I can sign up for workshops based on my schedule and availability. After the first year, I can continue to attend workshops as I would like, but there is no attendance requirement.As a part of the program, I will be assigned a GOALS Advisor who will support me as a life and career coach. Students are required to meet with their GOALS Advisor on a bi-weekly basis. Meetings can be more frequent if a student feels they would benefit from weekly sessions.As a part of the program, I will need to participate in a minimum of four work-based learning experiences throughout the year. A schedule will be provided in early 2023, with opportunities available every month.
Program Eligibility
I have a diagnosis of autism, another intellectual/developmental disability, and/or a learning disability. I understand that I will need to provide documentation to support this diagnosis at the point of intake. Documentation may also be uploaded below. Acceptable documentation includes a medical report, psychological report, psychosocial report, psychoeducational report, and/or an Individual Education Program (IEP).I am between 16 and 26 years old.I can commit to regular meetings with a GOALS advisor and participation in related workshops.I am a current resident of New York City or Long Island.
OPTIONAL: Please upload any documentation you would like to submit with your application, including supporting documentation for the disability diagnosis requirement. If you don't turn in the documentation here, you will need to provide it during your intake appointment.

Cancelof
Should be Empty:

Generating Opportunities through Advocacy and Learning that Promote Success (GOALS)

Student/Client Information

Parent/Guardian Contact Information

About the GOALS Program

Program Eligibility