Please enter your information below and we will work to determine if you are eligible for ETV funding!

First Name

Last Name

Email

Phone

Birthdate

In foster care at least one day on or after 16th birthday? Yes No

What state did you participate in DCS services? Indiana Arizona Maryland Ohio

Did you exit foster care via reunification with your biological parent(s)? YesNo

Are you less than 26 years old? Yes No

Have you received ETV funds in the past? Yes No

How many semesters did you receive ETV funding? 0-5 6-9 10+

Are you currently enrolled/planning on enrolling in in college or a certificate program? Yes No Unsure

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