DREAMCATCHER COMMUNITY RESOURCE CENTER Enrollment Application

DREAMCATCHER COMMUNITY RESOURCE CENTER
Thank you for your interest in Dreamcatcher Community Resource Center (CRC). We are excited you are considering becoming a member. It is important to clarify important aspects of our program and eligibility for services, resources, and training.
Dreamcatcher CRC is a program that offers workforce and leadership development, counseling, community involvement opportunities, and education. We are not a school.
Before becoming a member of Dreamcatcher CRC, you must participate in our orientation process (Mental Toughness Orientation) and be accepted to the program. Mental toughness orientation happens at the start of every trimester during the school year. If you are invited to join Dreamcatcher CRC, you may enroll in the high school diploma or join training opportunities. The only way to access the academic component (high school diploma) is to be a member in good standing.
Being a member in good standing means following all program policies and guidelines as outlined in the member success guide. If a member is not in good standing, the member chooses to self-select out of the program. Self-selecting from the program means the member loses access to the high school diploma. They may be able to access supportive services on a case-by-case basis.
Dreamcatcher CRC partners with YouthBuild Charter School of CA (YCSC), which provides the high school diploma. To access the high school diploma, you must be a member of Dreamcatcher CRC. It is vital to understand that YCSC does not enroll nor dismiss members.
Members enrolled at Dreamcatcher CRC will also be required to enroll in services through the Hawkeye Workforce Inc program. This partnership provides students with access to additional workforce development resources, including career exploration, job readiness training, work-based learning opportunities, employment support, and other services designed to help prepare them for future education and career success.Enrollment in the Hawkeye WIOA program allows students to benefit from a broader network of support and opportunities as they work toward their academic and career goals. Members who do not qualify to work with Hawkeye will be referred to work with Southeast Los Angeles County Workforce Development Board (SELACO).

Engaging in illegal or dangerous behaviors is considered a voluntary self selection of program membership These actions indicate their voluntary withdrawal from participation in the Dreamcatcher CRC program:
1. Bringing, Using, or Possession of drugs or drug paraphernalia, whether the member brought it to the program site or not
2. Bringing, Using, or Possession of a weapon on campus, whether the member brought it to the program site or not
3. Fighting, Threatening, or Assault of any Type on a member or staff member
Additionally, a member may lose good standing in the program for repeated violations of the member success guide. That process for loss of good standing includes:
1. An initial conversation about the behavior or action
2. A contract outlining the behavior or actions that need to be corrected
3. Monitoring of the behavior or actions
When a member continues a prohibited behavior after signing a contract and discussing the issue with us, they show through their actions that they are choosing to end their program membership rather than change their behavior and will self-select out of the program.
Signing below indicates you have read and understand this notification and agree the member may self-select from Dreamcatcher CRC program without regard to initial status (foster, homeless, IEP), thereby losing access to program services, training opportunities, and educational components.
Prospective Member:
Date:
Parent/Guardian (Required if Minor):
Date:
Education Rights Holder:
Date:
Legal Representative (if applicable)
Date:
Wrap Around Team: (if applicable)
Date:
Probation/Parole Officer: (if applicable)
Date:
Other:
Date:
Other:
Date:
Other:
Date:
Staff Member:
Date:

DREAMCATCHER Community Resource Center
10931 Rosecrans Ave, Nowalk, CA 90650 562-800-5401 dreamcatchercrc@gmail.com
Enrollment Application
Applicant Information:
Applicant Information
Name

First NameMiddle InitialLast Name
Date of Birth

MonthDayYear
Date
Age
Street Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
City, State, Zipcode

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Format: (000) 000-0000.
Email
example@example.com
If Minor, Name of Parent(s)/ Guardian(s)
Phone Number
Format: (000) 000-0000.
Email
example@example.com

DREAMCATCHER Community Resource Center
10931 Rosecrans Ave, Nowalk, CA 90650-562-800-5401--dreamcatchercrc@gmail.com
Medical Information
Do you have any Medical Conditions?
If yes, please explain:
List any allergies:
List any physical activity restrictions:
List any dietary restrictions:
Additional comments:
Emergency Contacts
Contact #1:

First NameLast Name
Relationship
Street Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
City

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Format: (000) 000-0000.
Email
example@example.com

DREAMCATCHER Community Resource Center
10931 Rosecrans Ave, Nowalk, CA 90650 562-800-5401 dreamcatchercrc@gmail.com
Contact #2:

First NameLast Name
Relationship
Street Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
City

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Format: (000) 000-0000.
Email
example@example.com
Disclaimer and Signature
"I affirm that all information provided in this application is true and complete to the best of my knowledge. I understand that providing false or misleading information may affect my eligibility and could result in withdrawal from the program."
Note: A parent or legal guardian signature is required for all applicants under 18 years of age.
Applicant Signature:
Date:

MonthDayYear
Date
Parent/Guardian Signature:
Date:

MonthDayYear
Date
DREAMCATCHER Community Resource Center
10931 Rosecrans Ave, Nowalk, CA 90650 562-800-5401 dreamcatchercrc@gmail.com
Should be Empty:

DREAMCATCHER COMMUNITY RESOURCE CENTER

DREAMCATCHER Community Resource Center

Enrollment Application

Education

Additional Information:

DREAMCATCHER Community Resource Center

Medical Information

Emergency Contacts

Disclaimer and Signature

DREAMCATCHER Community Resource Center