Home Services Writing Reading Math Spanish Organizational Tutors Apply to Project Success How to Apply High School Students Current UWO Students Transfer Students Current Students Policies & Procedures Math 100, 101 & 103 Supplemental Review (SR) Lab Hours Tutor List Upcoming Events & Reminders Summer Program Summer Courses Summer Program FAQ’s Benefits of Attending the Summer Program Summer Program To-Do List Resources School Counselors & Special Education Teachers Parents Current Students UW Oshkosh Faculty & Staff Upcoming Transition Fairs & High School Visits Alumni Stories About Us Philosophy Orton Gillingham Methodology Mission History Statistics Contact Us Staff Directory Contact Us Project Success Nursing Education Building, Rm 26 Phone: (920) 424-1033 View more Project Success contact info... Applying to Project Success Donate to Project Success Project Success Application Personal InformationName* First Last Date*mm/dd/yyyy Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSaint MartinSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country Phone*(###) ###-####Email* Date of Birth*mm/dd/yyyy Age*Parents NamesFather* First Last Mother* First Last Parent Phone Number*(###) ###-###Parent Email* Residency StatusAre you a Wisconsin or Minnesota resident for tuition purposes?*Yes, I am a Wisconsin or Minnesota resident and plan to pay resident tuitionNo, I am a non-resident and plan to pay non-resident tuitionWhat is your expected High School Graduation date?*mm/dd/yyyy Information About Your DisabilityDate of initial evaluation of dyslexia or learning disability*mm/dd/yyyy **Please send a copy of your most recent documentation with this application**Please provide the following information on the person who first or most recently diagnosed your learning disability or dyslexia:Name* First Last Professional Title*What is the date of your most recent evaluation of your disability?*mm/dd/yyyy Do you have a copy of your most recent evaluation?*YesNoPlease check the areas that are most difficult for you because of your disability:Reading* Word Attack Reading Rate Comprehension Written Expression/ Spelling* Spelling Writing Mechanics Paragraph/ Theme Development Mathematics* Basic Facts Story Problems Basic Operations/ Calculations Study Skills* Note-taking Test Preparation Time Management High School InformationPlease provide the name and address of the high school where you graduated or are currently attending:School Name*School Location*Did you receive Special Education Services during High School?*YesNoDid you have an Individualized Education Plan?*YesNoWhat types of services did you receive?*Extra Testing TimeTest ReaderResource RoomPostsecondary Education InformationHave you attended a postsecondary school such as a college, university or technical school?*YesNoSchool NameSchool LocationStart Datemm/dd/yyyy End Datemm/dd/yyyy Credits EarnedGPA0.00Did you receive accommodations for your disability at this institution?YesNoWhat types of services did you receive?Extra Testing TimeTest ReaderResource RoomHow did you hear about Project Success?*Did you see a representative of Project Success at a Transition fair and/or campus visit?*YesNoIf so, which state/fair and/or Project Success representative?Application To-Do ListPlease make sure to include the follow when submitting the application:Copy of Most Recent Disability Documentation*ACT Scores*High School Transcript complete through Junior Year*Senior Year Schedule*Hand-written Letter of Interest*Date sent in*mm/dd/yyyy Project Success recommends applying to the program during second semester Junior year or first semester Senior year.