DMF INDEPENDENT LIVING PROGRAM

"Experience an Opportunity of A Lifetime while Creating Memories that Last Forever"

$1,500 Per Session

No Application Fee (Apply Below)

The Dan Marino Foundation is offering an exciting opportunity for young adults with disabilities to experience living away from home.

Young adults enrolled in the program will participate in activities focusing on employment, health, personal finance , and leadership. Social activities include art, fitness, cooking, and group recreational activities. Participants will learn time management, meal preparation, and self-care skills. Staff will provide 24-hour support and facilitate all activities during the day as well as participant supervision.

Florida International University

Modesto A. Maidique Campus

Session 4: July 2 - July 7


APPLICANT INFORMATION

Which session are you interested in? *
Please select as many as you would like
Name *
Name
Birth Date *
Birth Date
Gender *
Address *
Address
Home *
Home
Cell *
Cell
Graduation or Expected Graduation Date *
Graduation or Expected Graduation Date
If yes, when and what types of accommodations?
Parent or legal guardian information
Parent or Guardian *
Parent or Guardian
Parent or Guardian Address *
Parent or Guardian Address
Best Contact Number for Parent or Guardian *
Best Contact Number for Parent or Guardian
Do you have a court-ordered legal guardian? *
Primary Disability Diagnosis *
Documentation of Disability *
ADDITIONAL INFORMATION
Have you ever been expelled from school? *
Have you ever been arrested, convicted of, and/or have charges pending for any criminal offense *