Please complete this application form if you are interested in applying to the 2021-2022 Project SEARCH program at Dublin Methodist Hospital. Once you complete the form, click the submit button at the bottom.


Name & Address


Personal Information


Parent/Guardian Information


Employment Plans


Transportation


Service Agencies


Medical History


Behavioral Summary


Student Response


Parent/Guardian Response


Student Contract

This contract will be required to be signed upon acceptance into the program.


I understand that I have been accepted into the Project SEARCH program and must abide by the following terms and conditions:

* I will get apply for and accept a job upon completion of the program.

* I understand that employment is not guaranteed.

* I will order and purchase the Project SEARCH uniform prior to the start of the program.

* I will complete at least two unpaid internships within Dublin Methodist Hospital.

* I will attend the program every day from 8 a.m. to 2:10 p.m., Monday through Friday.

* I will adhere to the Project SEARCH attendance policy.

* I understand that the Project SEARCH program follows the Tolles Career & Technical Center calendar.

* I will dress appropriately, wear the required uniform and have appropriate hygiene.

* I will call my instructor when I am absent or tardy.

* I will follow all the rules established by the program and Dublin Methodist Hospital.

* I will attend team meetings with my VR counselor, parents, teachers, and others.

* I will be an active participant and communicate any issues at our team meetings.

* At completion of this Project SEARCH program, I understand it is the intention that I will receive my high school diploma and seek competitive employment.


Tolles Career & Technical Center often publishes school promotional material news articles in local papers and/or Tolles' website material featuring student achievement and highlighting school activities. Tolles may wish to use your photograph and other school related information in one or more of these articles or in a copy of a school brochure promoting Tolles.


Unless we hear otherwise from you in writing, your parent and student signatures below give the school district permission to use photos to promote student and school accomplishments.


I have read the above terms and conditions and agree to accept my placement in the Project SEARCH program. I understand that I may be asked to leave Project SEARCH if I fail to follow the terms and conditions.



Terms of Application

1. A student cannot enter Project SEARCH unless all requirements for graduation from the Associate School are met.

2. Final placement into Project SEARCH will depend upon the Individual Education Plan (IEP) meeting, where applicable.

3. Release: The student records concerning the applicant may be transferred to Tolles Career & technical Center from the associate school for review/use by the Project SEARCH staff.

4. Equal Opportunity: Project SEARCH placement will be made without regard to race, color, national origin, sex, age, religion, or presence of a disability.

5. A two-week trial period will be required of all accepted enrollees. The parent and student agree to comply with this procedure.