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Andrew Moser, Assistant Secretary - page 6 / 8

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ELIGIBILITY CRITERIA

ACCEPTABLE DOCUMENTATION (Only one of the following is required )

BASIC SKILLS DEFICIENT

Assessed by a Generally Accepted Standardized Test

School Records

PREGNANT OR PARENTING

Applicant Statement

Birth Certificate

Hospital Record of Birth

Medical Card

Physician's Note

Referrals from Official Agencies

School Program for Pregnant Teens

School Records

Statement from Social Services Agency

SCHOOL DROPOUT

Applicant Statement

Attendance Record

Dropout Letter

CASH PUBLIC ASSISTANCE

Copy of Authorization to Receive Cash Public Assistance

Copy of Public Assistance Check

Medical Card showing Cash Grant Status

Public Assistance Identification Card showing Cash Grant Status

Public Assistance Records/Printout

Refugee Assistance Records

OFFENDER

Applicant Statement

Court Documents

Halfway House Resident

Letter of Parole

Letter from Probation Officer

Police Records

INDIVIDUALS

WITH DISABILITIES

NOTE: If an individual declares

a disability, any of the listed items

may be used.

Letter from Drug or Alcohol Rehabilitation Agency

Letter from Child Study Team Stating Specific Disability

Medical Records

Observable Condition (Applicant Statement Needed-See Part III)

Physician's Statement

Psychiatrist's Diagnosis

Psychologist's Diagnosis

Rehabilitation Evaluation

School Records

Sheltered Workshop Certification

Social Service Records/Referral

Social Security Administration Disability Records

Veterans Administration Letter/Records

Vocational Rehabilitation Letter

Workers Compensation Records

HOMELESS OR

RUN-AWAY YOUTH

Applicant Statement

Written Statement from an Individual Providing Temporary Residence

Written Statement from Shelter

Written Statement from Social Service Agency

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