Date Received: _______________
Approved: _____ Rejected:
Amount Approved: ___________
Teen Grant/Enrichment Fund
Application
The Teen Grant program assists youth ages 16 and older who live in DCYF sponsored out of home care to receive money
for purposes that will help a youth better prepare for independence and adulthood. YESS participants may also apply.
The Youth Enrichment program assists children ages 15 and under who live in DCYF sponsored out of home care to
receive money for purposes that will help a child better themselves and explore creative programming to enrich their
lives.
Requests that will enhance a youth’s self esteem, skills, or knowledge, are encouraged. Applications that represent
requests more likely to be considered as “presents” or “gifts” are much less likely to be approved.
Computers/laptops are only allowed to be purchased once every three years for youth ages 12 and up.
*Grants not picked up after 3 months will not be honored.
**An applicant who uses their check for purposes other than those that were approved by the program will be
penalized.**
Please check the box for the program to which you are applying
Teen Grant (ages 16+)
Youth Enrichment (birth-15)
Name:
Date of Birth:
Age:
Mailing Address:
City:
State:
Phone Number:
Are you Hispanic?: □Yes
Zip:
Email address:
□No
The terms "Hispanic" or "Latino" refer to persons who trace their origin or descent to Mexico, Puerto Rico,
Cuba, Spanish speaking Central and South America countries, and other Spanish cultures. People who identify
their origin as Hispanic or Latino may be of any race.
Race:
□ 2 or More Races
□ Alaskan Native/Native American
□ Asian
□ Black or African American
□Native Hawaiian or Other Pacific Islander
□White
□ Unknown
Teen Grant/Youth Enrichment
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Check the one that applies: YESS
Non-Relative Foster Home
Independent Living
Relative Foster Home
Group Home/Residential
Foster Parent(s) / Residential Program Name:
Staff / Case Manager Name:
Phone Number:
DCYF Worker (*If over 18, name of last DCYF worker):
Phone Number:
Amount requested from the fund/grant: $
(up to $300.00)
Total cost of what you want to do: $
If there is a difference, how will you pay the remaining balance?
By what date do you need the money?
Payments, whenever possible, will be made directly to the store, company, etc... In the
event your application is approved, list for whom the check(s) should be made payable.
For many Teen Grant requests, American Express gift cards are used to supply funds.
Check payable to:
Amount
For information
contact:
Telephone Number
For Teen Grant, checks will be mailed to the youth at the address provided
above. For Youth Enrichment, checks will be mailed to DCYF Social Workers,
Program Staff, or Foster Parents.
Teen Grant/Youth Enrichment
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1. Tell us about what you want the money for.
*Please attach printed information/documentation – example if
you want a computer, attach information on the make, model,
store you want to get it from, etc. If you are looking to get
reimbursed for an item that has already been purchased, please
attach a copy of the vendor receipt. (More documentation may
also be required.)
2. Tell us about how this is going to help you achieve your independence
or enhance your self esteem, skills, or knowledge.
I certify that the information on this application is true and complete to the best of my knowledge.
I give Foster Forward permission to verify any information on this form (including school
enrollment) and to obtain additional information about this request from my social worker, foster
parent, advocate, or YESS case manager if necessary.
Applicant’s Signature
Date
Return this application to:
Foster Forward
TG/YE Program
55 South Brow Street
East Providence, RI 02914
Tele: 438-3900 x200
Fax: 438-3901
Teen Grant/Youth Enrichment
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