First Name *

Last Name *

If married/divorce/adopted, what was your last name when you were receiving foster care services?

Date of Birth *
- Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 - 2024 2023 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 1919 1918 1917 1916 1915 1914 1913 1912 1911 1910 1909 1908 1907 1906 1905 1904 1903 1902 1901 1900

Status with GVSU? *
- Select Option Incoming Freshman Current Student Potential Student

G-number

Email *

Phone *

Were you in foster care or other out of home placement after the age of 13? *
- Select Option Yes No

What state did you receive foster care services in? *

What county did you receive foster care services in? *

Are you under the age of 23? *
- Select Option Yes No

Unaccompanied homeless youth are students (or future students) who lack safe, stable housing and who are not in the care of a parent or guardian. They may have run away from home or been forced to leave by their parents. Unaccompanied youth live in a variety of temporary situations, including shelters, the homes of friends or relatives, cars, campgrounds, public parks, abandoned buildings, motels, and bus or train stations. Unaccompanied youth do not receive financial support from their parents and do not have access to parental information.

Are you or have you experienced homelessness with in the last year? *
- Select Option Yes No Unsure

How did you hear about Fostering Laker Success Program? *
GVSU Website
GVSU Admission Staff
DHS Worker
High School Counselor
Fostering Laker Success Staff
Family or Friend
Fostering Success Michigan Website
Not listed Please specify a value for How did you hear about Fostering Laker Success Program?

Eligibility Statement

I understand GVSU/Fostering Laker Success Staff may contact  the state human service agency, or any other relevant agency, to verify my eligibility using information provided on the online FLS  application.  Submission of this application does not guarantee admission to GVSU nor acceptance into the Fostering Laker Success Program. Program participants are required to complete the Intake process for program entry.

 I agree that I will hold GVSU/Fostering Laker Success  harmless as a result of contact with any such agency.

Reminder:

Applicants who are still in high school must also apply for the Tuition Incentive Program before graduating from high school by calling (888) 447-2687.  Michigan Fostering Futures Scholarships are due August 1. 

I have read the eligibility statement and agree to submit my application for eligibility determination *
- Select Option Yes No