JCCC CONNECT: College Opportunity Network to Navigate Education, Career and Transition Application Process and Checklist 2022-2023 Academic Year
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JCCC CONNECT: College
Opportunity Network to
Navigate Education, Career
and Transition
Application Process and
Checklist
2022-2023 Academic Year
1|PageApplication Information and Process
Program Description
JCCC CONNECT is a two-year transition program for adults with intellectual/developmental
disabilities. Graduating students will receive a continuing education certificate in Career
Development and Leadership. During the course of study, students will participate in CONNECT
specific courses around life planning, career development and independent living, participate in
on-campus internship opportunities, take credit courses (for credit or audit) and/or traditional
continuing education courses and be fully immersed in the student life of JCCC.
Course of Study
Each semester, students will be enrolled in three (3) CONNECT specific courses that will be held
Mondays, Wednesdays, and Fridays from 9 a.m. until 12 p.m. Additionally, each semester
students will be enrolled in a one-hour Campus Involvement Seminar course to track campus
involvement and peer mentorship hours. Beginning in the second semester, students will be
eligible to enroll in elective coursework that may include credit courses for credit or audit
and/or traditional continuing education courses. Throughout the first semester, students will
work with Supported Education staff and their planning team to choose a path for elective
coursework. Below are descriptions of the CONNECT specific courses that each student must
complete, by semester.
Fall Semester 1- Course Name Course Description
Cavalier Connections Intended for first year students, this course will help
you explore the JCCC campus and get connected with
its resources. From Clubs to ID cards, explore what it
means to be a JCCC Cavalier!
Foundations of Independent Living Focused on daily living skills necessary to live an
independent life, students will practice skills in
personal care, home maintenance, food preparation,
problem solving, and personal organization.
Communication Skills The study of verbal, non-verbal and written
communication within relationships, with an emphasis
on improving professional and personal
communication. Social media safety and basic social
skills such as cues in conversations will be covered.
Spring Semester 2- Course Name Course Description
Shifting the Power Foundations in self-advocacy and self-determination
are explored in this course. Learn how to find and use
your own voice as you transition to adulthood.
Health and Wellness Explore topics in physical fitness, nutrition, healthy
personal relationships, risky behaviors, and other
wellness related topics that young adults face.
Students in this course will utilize the Lifetime Fitness
gym on campus as part of the coursework.
2|PageJob Readiness Universal job skills such as teamwork, communication,
flexibility, customer service, problem-solving, and
creative thinking are explored in this hands-on course.
Begin person centered career planning to explore
interests and potential internships. This is a pre-
requisite to Internship I.
Fall Semester 3- Course Name Course Description
Financial Literacy Gain the skills needed for managing personal finances:
creating a budget, banking, credit and debit cards, and
savvy shopping including hidden costs. Gain
understanding of paycheck and tax information.
Transitions I: Planning for Independent Living Using the skills learned in Foundations of Independent
Living, create a living plan for life after college. Set
goals for independent living, including using
community resources, finding and caring for a home
or apartment, discussing roommates, exploring leisure
activities, etc. This is a pre-requisite to Transitions II.
Internship I During this course, students will prepare for their first
on campus internship. Students will learn
interviewing skills, resume writing and job search
skills. Internships will take place both in and outside
of class time. This is a pre-requisite to Internship II.
Spring Semester 4- Course Name Course Description
Technology in the Workplace Students will learn basic computer skills and common
software used in workplaces, such as word processing
programs, e-mail, excel and online tools such as cloud-
based systems in this eight-week course.
Transportation Training Students will learn how to navigate public
transportation systems and ride sharing services in
this eight-week course. Hands on experience will be
included.
Internship II During this course, students will prepare for their
second on campus internship. Students will engage in
career exploration, take interest and strengths
surveys, and prepare a career plan for next steps after
college. Internships will take place both in and outside
of class time.
Transitions II: Future Planning Students will engage in creating a vision for their long-
term future. Topics will include personal goals,
relationship goals, employment, independent living
and health and wellness.
Program Fees
Each semester, students will pay a $550 CONNECT program fee. In addition, beginning in
semester two, students will also be responsible for paying standard JCCC tuition rates for any
credit or continuing education elective courses that they are taking. For reference, standard
JCCC tuition rates can be found here: https://www.jccc.edu/admissions/tuition/rates.html
During the 2022-2023 academic year, financial aid will not be available for CONNECT fees.
3|PageAdmissions Criteria
Prior to applying to the CONNECT program, students should ensure that they believe they meet
the required admissions criteria listed below:
1. Students must have been diagnosed with a disability, with emphasis on intellectual and
developmental disabilities and autism spectrum disorders, prior to the age of 18, as
documented by either educational, medical, or psychological evaluations by a qualified
professional.
2. Students must be currently or were formerly eligible for special education and related
services under the Individuals with Disabilities Education Act (IDEA), including a student
who was determined eligible and was home-schooled or attended private school.
3. Students must demonstrate a high level of independence and emotional maturity:
a. Ability to administer medications, manage medical conditions and administer
self-care without assistance.
b. Capable of navigating the JCCC campus with minimal assistance.
c. Ability to complete the interview process for acceptance without the assistance
of a parent/guardian.
d. Free from behaviors that would be disruptive to the learning and campus
environment, including physical or verbal aggression.
e. Demonstrate the ability to appropriately interact with peers and follow
guidelines, including the JCCC Student Code of Conduct.
f. Able to communicate with others verbally, through sign language or
communication device with enough expressive language to advocate for
themselves in both routine and unplanned situations (i.e., lost on campus,
medical emergency, etc.).
g. Ability to remain unsupervised for a minimum of four hours.
4. Students must demonstrate independently a desire to pursue educational, employment
and social experiences in a community college setting, including agreeing to attend and
participate in all CONNECT courses and activities as prescribed.
5. Students must demonstrate basic proficiency in reading, writing and math.
Application Process
Step One: Complete the application and submit by the deadline.
Each applicant should follow the steps given on the webpage to submit the application
materials by the assigned deadline. Priority deadline: 1/31/22. Final deadline 2/15/22.
Step Two: Packet Review
Each application packet will be reviewed by the Programs Manager to ensure that the applicant
meets the admissions criteria, that the application is complete and that it was received by the
4|Pagerequired deadline. All applications meeting these requirements will move forward to step three. Step Three: Admissions Committee Review An Admissions Committee, comprised of Supported Education, Career Development Center, Counseling and ACCESS Services staff will review applications and select applicants to move forward to step four. Applications will be anonymous during this review phase. Three categories will be given priority consideration: applications submitted by the priority deadline, Johnson County residents and applicants who have previously taken CLEAR classes through JCCC. Step Four: Interview Applicants and their parent/guardian will attend a personal interview with Supported Education staff. Step Five: Admissions Decision Chosen applicants will be notified in writing, via e-mail, about their acceptance into the CONNECT program. During the application and selection process, members of the Supported Education staff will be unable to answer any questions about the status of your application. After each step is completed, you will receive an e-mail letting you know if your application has moved forward to the next step. If your application has not moved forward, you will be given suggestions for strengthening your application for future years. 5|Page
Application Checklist ☐ Student Application Form ☐ Student Questionnaire ☐ Family/Guardian Application Form (Parent/Guardian completes) ☐ Behavioral and Skills Assessment (Parent/Guardian completes) ☐ Parent Questionnaire (Parent/Guardian completes) ☐ Most recent IEP or 504 Plan ☐ Educational and Psychological Evaluation, completed by a psychologist or other qualified professional within the last three years, documenting IQ and diagnoses. ☐ Contact information for three references. References should have known the applicant for at least one year and should represent the following: one educational reference (teacher, case manager, etc.), one employment/activity reference (supervisor or sponsor) and one reference of your choice (community involvement, a second educational or employment reference, etc.) All references should be non-family members. References should be notified that they will be asked to complete an e-mailed reference form by 2/22/22. ☐ Copy of Guardianship agreement, if applicable. 6|Page
JCCC CONNECT: College Opportunity Network to Navigate Education, Career and Transition
Student Application Materials
Dear CONNECT Applicant,
Congratulations on reaching the milestone of completing high school and beginning your future
planning. College is an exciting step in your future, and we are thrilled to see that you are
considering the CONNECT program as part of that journey.
In the following application materials, you are asked to provide many pieces of documentation.
This helps the admissions committee to get a complete picture of who you are as a student and
what your personal goals are to ensure that the CONNECT program can help you reach those
aspirations.
Along the way, please provide honest input and complete each document in its entirety. Pay
close attention to the deadlines and checklist as you make your way through the process. You
should complete these materials as independently as possible, with minimal support if needed.
Thank you for your interest in the CONNECT program and for your thoughtful consideration of
the materials in this application.
7|PageJCCC CONNECT: College Opportunity Network to Navigate Education, Career and Transition
Student Application Form
Please complete the following form in its entirety. Please type or print legibly. The information
you provide will be confidential and used only to determine eligibility for the CONNECT
program.
Student Information
Full Legal Name: Preferred Name:
Date of Birth: E-mail address (required):
Address: City, State, Zip:
County of Residence: # of years at current residence:
Home Phone #: ( ) Cell Phone #: ( )
Are you a US Citizen? Student ID # (if previous JCCC/CLEAR
☐ Yes ☐ No student- leave blank if N/A or unknown):
Educational Information
Please include secondary and any post-secondary information.
Name of School Years attended Completed? Y or N
8|PageDid (or will) you receive: ☐ High School Diploma ☐ Equivalent
Month and Year Diploma/Equivalent was awarded (or is anticipated): _____________________
Do/did you have an IEP? ☐ Yes ☐No (if yes, a copy must be submitted)
Do/did you have a 504 Plan? ☐ Yes ☐ No (if yes, a copy must be submitted)
Did you participate in general education classes? ☐ Yes ☐ No
Please list any general education courses that you participated in during your most recent year
of high school: _________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Did you have assistance in the classroom (i.e. a paraprofessional or aide?) ☐ Yes ☐ No
If yes, what type of support was provided? _____________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Please describe any assistive technology, accommodations or modifications used in the
classroom according to your IEP/504 Plan: ___________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Have you previously taken any CLEAR programming at JCCC? ☐ Yes ☐ No
If yes, please indicate which program (check all that apply):
☐Expansion, with a post-high program
☐Expansion, independently
☐Saturday classes
Have you previously taken any credit courses at JCCC? ☐ Yes ☐ No
If yes, please list the courses and semester taken: _______________________________
______________________________________________________________________________
______________________________________________________________________________
Please list any formal disciplinary issues/actions during the last two years of school: _________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
9|PageVolunteer/Activities Information
Please list any volunteer experiences and extracurricular activities that you have participated in
over the last three years. Please list experiences both at school and in the community. You
may attach additional paper if needed.
Organization Event/Activity Description Dates participated
Employment History
Please list all paid work experiences and employment internships. Attach additional paper if
needed.
Employer: Position:
Job Duties: Paid or internship:
Dates employed: Reason for Leaving (if applicable):
Employer: Position:
Job Duties: Paid or internship:
Dates employed: Reason for Leaving (if applicable):
10 | P a g eEmployer: Position:
Job Duties: Paid or internship:
Dates employed: Reason for Leaving (if applicable):
Employer: Position:
Job Duties: Paid or internship:
Dates employed: Reason for Leaving (if applicable):
Which position listed did you enjoy the most and why? _________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
What types of support did you have in your employment positions (i.e. job coach, etc.?) ______
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Medical/Disability History
Please provide a complete description of your medical history, including any diagnoses or
disabilities:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
11 | P a g ePlease list all medications that you are regularly taking and the condition they are taken for:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Do you have any medical conditions that require special diets (i.e. diabetes, food allergies, food
intolerances, etc.?) ☐ Yes ☐ No
If yes, please describe how you manage those conditions independently: ____________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Do you regularly see a therapist or other mental health clinician? ☐ Yes ☐ No
If yes, please describe the services received and how often? _______________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Do you receive private (outside of school) physical, occupational and/or speech therapy?
☐ Yes ☐ No
If yes, please list the services and how often you receive them: ____________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Do you require any mobility assistance? ☐ Yes ☐ No
If yes, please describe your mobility aides (i.e. wheelchair, crutches, etc.) ____________
______________________________________________________________________________
______________________________________________________________________________
Is there any other information you would want JCCC CONNECT staff to know in regard to your
medical history for your safety on campus? __________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
12 | P a g eReference Information
Please include contact information for three references. One should be an educational
reference (teacher, job coach, etc.), one should be an employment/activities reference
(supervisor, activity sponsor, etc.) and the third is of your choosing (community involvement, a
second educational or employment reference, etc.) References should not be family
members. Please inform your references that they will be asked to complete an e-mailed
reference form by 2/22/22. Please make sure to choose references who have known you for at
least one year, know your career and independent living goals AND who will complete the
reference form by the date provided.
Name Reference Type (educational, employment,
etc.)
Job Title Years known
E-mail Phone
Name Reference Type (educational, employment,
etc.)
Job Title Years known
E-mail Phone
Name Reference Type (educational, employment,
etc.)
Job Title Years known
E-mail Phone
13 | P a g eStudent Questionnaire: Please attach your responses to the following questions. Please type
or write legibly.
1. Why are you interested in the CONNECT program?
2. What are your goals in regard to career, independent living and personal relationships?
3. What are your hobbies and interests and how much time do you spend engaged in
these activities?
4. What was your favorite subject in school? Why?
5. Describe a teacher that you had a good working relationship with. What were the
characteristics of that teacher that made them easy to work with?
6. Describe a time when you had a conflict with a friend. How did you handle it and what
was the outcome?
7. Describe your social media presence. What apps do you use and what do you find
challenging about managing social media?
8. Do you feel you are ready for college? Why or why not? What have you done to
prepare for the transition?
9. What are your feelings about your family being involved with your college experience?
How much or how little do you expect them to be involved?
10. What are you most nervous about in regard to college? How will you manage these
concerns?
14 | P a g eJCCC CONNECT: College Opportunity Network to Navigate Education, Career and Transition
Parent/Guardian Application Materials
Dear Parents/Guardians of CONNECT Applicants,
Thank you for your interest in the JCCC CONNECT program. The transition from high school to
college is an exciting time in your life, as well as your student’s life, with many new experiences
on the horizon.
As your student begins the application process for the CONNECT program, there will be times
when we will seek information and input from you along the way. There will also be many
times during the process that your student will be required to provide information without
assistance. Each step of the way, you and your student will be guided by the Supported
Education Programs staff at JCCC.
Your honest input in the following documents is vital in understanding where you believe your
student is with various skills. Please thoughtfully consider your answers as you complete the
following forms:
• Family/Guardian Application Form
• Behavioral and Skills Assessment
• Parent Questionnaire
Thank you again for your interest in the JCCC CONNECT program and for your input in the
application process.
15 | P a g eJCCC CONNECT: College Opportunity Network to Navigate Education, Career and Transition
Family/Guardian Application Form
Please complete the following form in its entirety. Please type or print legibly. The information
you provide will be confidential and used only to determine eligibility for the CONNECT
program.
Student Name: _________________________________________________________________
Form Completed By (Name/Relationship to applicant): _________________________________
Is the student his/her own guardian? ☐Yes ☐ No
If no, are you the legal guardian of the student? ☐ Yes ☐ No
If you are not the legal guardian of the student, please provide the name of the legal guardian
here: _________________________________________________________________________
Preferred Emergency Contact for your student:
Name: ________________________________________________________________________
Phone Number: ________________________________________________________________
E-mail: _______________________________________________________________________
Students Primary Residence:
☐ Both Parents ☐ Mother ☐ Father ☐ Guardian (if different than parent)
☐ Own home (apartment, etc.) ☐ Other: __________________________________________
Mother/Guardian:
Name: Home Phone:
Employer: Work Phone:
E-mail: Cell Phone:
Father/Guardian:
Name: Home Phone:
Employer: Work Phone:
E-mail: Cell Phone:
16 | P a g eJCCC CONNECT: College Opportunity Network to Navigate Education, Career and Transition
BEHAVIORAL AND SKILLS ASSESSMENT
PARENT VERSION
Student Name: ________________________________________________________________________
Form Completed By (Name/Relationship to applicant): _______________________________________
This form should be completed by the applicant’s parent, guardian, or caregiver. Please give your honest
assessment of each of the skills listed below. If you have not seen the applicant perform the skill listed, or it does
not apply, please mark “Unsure/Not Applicable.” Please type or print comments legibly.
Interpersonal/Social Skills With no With With With Unsure/
assistance minimal moderate significant/ Not
assistance assistance complete Applicable
assistance
Engages in social activities.
Has the ability to problem solve.
Participates in informal conversations with others.
Responds appropriately to authority figures.
Plans/initiates social events.
Communicates opinions appropriately.
Forms and maintains friendships.
Manages conflict with peers.
Establishes boundaries in relationships.
Uses social media/texting appropriately.
Please provide more information for any “significant/complete assistance” responses:
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Community/Safety Skills With no With With With Unsure/
assistance minimal moderate significant/ Not
assistance assistance complete Applicable
assistance
Understands safety when in groups of strangers.
Knows how and when to find or call for help.
Uses community resources.
Ability to be unsupervised for at least 4 hours.
Carries appropriate identification.
Understands and communicates medical needs.
Understands emergency procedures (fire, etc.)
Can administer daily medications as appropriate.
Understands what medications to take to solve
common symptoms (headache, cold, etc.)
Please provide more information for any “significant/complete assistance” responses:
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
17 | P a g eIndependent Living Skills With no With With With Unsure/
assistance minimal moderate significant/ Not
assistance assistance complete Applicable
assistance
Demonstrates good hygiene practices daily.
Understands and uses public transportation.
Uses cash effectively (has enough, counts change.)
Uses a bank account.
Can prepare a healthy meal for themselves.
Plans and schedules appointments.
Effectively manages time.
Gets adequate sleep.
Sets and uses an alarm to wake up.
Arrives to events on time.
Understands own disability/diagnoses.
Please provide more information for any “significant/complete assistance” responses:
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Career Development Skills With no With With With Unsure/
assistance minimal moderate significant/ Not
assistance assistance complete Applicable
assistance
Attends work as scheduled.
Able to work as a team/get along with co-workers.
Able to work independently.
Remembers passwords for computer processes.
Can use basic office software (Word, e-mail, etc.)
Composes written communication.
Follows verbal directions.
Asks questions for clarification.
Dresses appropriately for the job.
Communicates with supervisor appropriately.
Demonstrates customer service skills.
Completes assigned tasks.
Please provide more information for any “significant/complete assistance” responses:
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Please provide any additional information or comments that you think would be helpful regarding the
skills/behaviors listed in this assessment.
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
18 | P a g eParent Questionnaire: Please attach your responses to the following questions. Please type or
write legibly.
1. Why are you interested in this program for your student?
2. What are your students’ greatest strengths?
3. What are your largest concerns for your student?
4. Explain your expectation/understanding of parent involvement in the college
experience.
5. What goals do you have for your student in the areas of career, independent living, and
social relationships?
6. How will your student get to campus? Does your student have a driver’s license and/or a
vehicle? Will public transportation be a part of your overall plan?
7. Describe any concerns you have in regard to your student and unsupervised free time.
8. What resources or support do you feel are important for your student’s success?
9. How have you and other adults in your student’s life helped to prepare them for the
transition to college?
10. Does your student have a history of behavioral issues? Pay particular attention to any
history of physical, verbal or sexual aggression.
11. Is there other information you believe would be important for the admissions team to
know about your student that has not been covered here or in another document?
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