Guardian Scholars App

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Tell us about you

First name ✱
Last name ✱
Email ✱	Email is already used by another user
Phone ✱
Address ✱
City ✱
State ✱
Zip code ✱
County of Care ✱
G-Number ✱

What is your gender?

Male

Female

Trans male/man

Trans female/woman

Genderqueer/Gender non-conforming

Other

What is your ethnic background? ✱

Asian

Black/African American

Hispanic/Latino

Native American/Alaskan Native

Pacific Islander

White

Decline to State

Other

What kind of student are you? ✱

Are you a Skyline College "Promise Scholar"?

What is the average number of hours you work per week? ✱

Please enter "0" if you are not employed.

Have you completed your Financial Aid Application (FAFSA) or Dream Act? ✱

Yes

Have you applied for California Chafee Grant? ✱

Do you need assistance obtaining foster youth verification documentation?

Not required for admittance into the Guardian Scholars Program

10.

Do you receive extended foster care services with AB12? ✱

Yes

I don't know

11.

Are you involved with Independent Living Program ✱

Yes

12.

Do you participate in a Transitional Housing Program (THP or THP+)? ✱

13.

If you answered YES to the previous questions, in what county?

14.

What is your plan for housing while attending college? ✱

Living with family

Living with roommate(s)

Not yet determined

Other

15.

What is your current source of financial support? ✱

Please select ALL that apply.

Employment

Financial Aid

Chafee

AB12

Family

Public Benefits (Cash aid, disability, etc.)

Other

16.

What are the barriers to academic success and/or employment that you are currently facing? ✱

Please select any areas that may affect you.

Need child care	No transportation
Having family problems	Need help getting food
Need help purchasing books/school supplies	Coping with a violent relationship
Mental health	History of substance abuse or other addiction
Criminal records	Pregnant or parenting
Legal concerns (court date, probation, etc)	Lack of health coverage
Learning disability	Homeless or at risk of being homeless
None	Other

17.

Please provide the name and contact 1 emergency contact

This contact will only be used in case of emergency

Matrix row labels are in this column	Emergency Contact
Name	An answer is requiredValue for matrix segment M1, row R1, column C1
Relationship	An answer is requiredValue for matrix segment M1, row R2, column C1
Phone	An answer is requiredValue for matrix segment M1, row R3, column C1
Email	An answer is requiredValue for matrix segment M1, row R4, column C1

18.

I authorize the GSP Student Support Services Program staff to obtain records of data pertinent to my participation from other campus departments and programs. The GSP staff also has my permission to communicate verbally with other staff, faculty, and references provided below on my behalf. I understand that I can remove the following references at any time. ✱

Yes

19.

I certify that the staff may include my name and/or picture in publications and on the Skyline College website. The website highlights student accomplishments and participation on campus and Student Support Services program activities. I understand that I will receive no monetary payment for the use or reproduction of these photographs. ✱

Yes

20.

I authorize the Guardian Scholars Program (GSP) to engage with the county to verify former foster youth status. ✱

Yes