The Arc of Winnebago, Boone, & Ogle Counties

FOR PEOPLE

with

developmental disabilities

Help Yourself

Tutoring in Functional Reading and Math

Every person deserves the opportunity

toThis program will arrange assistance for youth and adults with developmental disabilities who want to increase their functional reading and math skills.

Reading and math are essential for employment AND independent living success.

Help Yourself is designed to offer assistance to youth or adults living in Winnebago, Boone and Ogle Counties who have a diagnosis of a developmental disability and are not receiving reading and math tutoring.

Typical examples of developmental disabilities are: mental retardation, autism, Down Syndrome, cerebral palsy, and epilepsy.

Developmental disabilities are present at birth or occurred before the age of 22 , are permanent and result in substantial functional limitations in three or more areas of major life activity.

Text Box: HELP YOURSELF Application Form
An Arc of Winnebago, Boone and Ogle Counties Program
Please tell us about yourself/your family member.
1. Do you have a diagnosis of a developmental disability?
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Do you live in the community in your own home or with family?
__________________________________________________________________________________________________________________________________________________

3. What is the goal you want to achieve by participating in this program?
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4. Describe the efforts you have made to achieve this goal.
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5. Tell us how you will continue working to achieve that goal after you leave this program?__________________________________________________________________________________________________________________________________________________

6. Are you willing to follow a tutoring plan based on an independent assessment?
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7. Have you or are you now receiving tutoring in reading or math?
_________________________________________________________________________

8. Are you receiving help with this goal from school or other organizations?
__________________________________________________________________________________________________________________________________________________
9. What supports do you have to help you successfully complete this program?
__________________________________________________________________________________________________________________________________________________
10. Please bring your latest IEP or MDC with you to your interview if you have one.
NAME___________________________________________PHONE___________________
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This program is not an entitlement. Selection for participation is at the discretion of The Arc.

r her own potential

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