Home About Us Philosophy Orton Gillingham Methodology Mission History Statistics Services Writing Reading Math BA Foreign Language Requirement Options Organizational Tutors Apply to Program How to Apply to Project Success High School Students Current UWO Students Transfer Students Current Students Program Forms Policies & Procedures Math 100, 101 and 103 Supplemental Review (SR) Lab Hours Tutor List Scholarships Upcoming Events and Reminders Summer Program Virtual Open House Summer Courses Summer Program FAQ’s Benefits of Attending the Summer Program Summer Program To-Do List Summer Program Scholarship Resources School Counselors and Special Education Teachers Parents Current Students UW Oshkosh Faculty & Staff Upcoming Transition Fairs and High School Visits Alumni Stories Contact Us Staff Directory Project Success Application Personal InformationName* First Last Date*mm/dd/yyyy MM slash DD slash YYYY Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code County* Date of Birth*mm/dd/yyyy MM slash DD slash YYYY Age*Phone*(###) ###-####Email* Parents/Guardians 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 tuition No, I am a non-resident and plan to pay non-resident tuition What is your expected High School Graduation date?*mm/dd/yyyy MM slash DD slash YYYY Information About Your DisabilityDate of initial evaluation of dyslexia or learning disability*mm/dd/yyyy MM slash DD slash 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 MM slash DD slash YYYY Do you have a copy of your most recent evaluation?* Yes No Please 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?* Yes No Did you have an Individualized Education Plan?* Yes No What types of services did you receive?* Extra Testing Time Test Reader Resource Room Postsecondary Education InformationHave you attended a postsecondary school such as a college, university or technical school?* Yes No School Name School Location Start Datemm/dd/yyyy MM slash DD slash YYYY End Datemm/dd/yyyy MM slash DD slash YYYY Credits EarnedGPA0.00Did you receive accommodations for your disability at this institution? Yes No What types of services did you receive? Extra Testing Time Test Reader Resource Room How did you hear about Project Success?*Did you see a representative of Project Success at a Transition fair and/or campus visit?* Yes No If so, which state/fair and/or Project Success representative? Application To-Do ListPlease make sure to include the following when submitting the application:Copy of Most Recent Disability Documentation*Max. file size: 5 MB.ACT/SAT Scores (Recommended, but not required)Max. file size: 5 MB.High School Transcript complete through Junior Year*Max. file size: 5 MB.Do not send report cards or similar documentsSenior Year Schedule for the whole year, both first and second semester*Max. file size: 5 MB.Hand-written Letter of Interest*Max. file size: 5 MB.Date sent in*mm/dd/yyyy MM slash DD slash YYYY Project Success recommends applying to the program during second semester Junior year or first semester Senior year.
