Unfaulted Application

Brave Girl,

You are welcomed and loved here! We want to give you the tools and resources needed to build a foundation for a successful life. No matter what your past involves, we believe you can thrive as an adult.

Unfaulted exists to build a foundation for young women who have aged out of the foster care system by connecting you with resources to help you attain employment, transportation, housing, education and relational support. We want to provide hope and equip you to be a successful, independent adult.

In this application, we want to get to know you and your hopes and dreams. We don’t want to offer something that isn’t needed, so please be honest and as detailed as possible in your answers.

If you want help filling out this packet, please email us at info@unfaulted.org

Thank you for trusting us. We don’t take that lightly.

First Name

Last Name

Phone Number

Date of Birth

Current Needs

Tell us a little about your current situation and what your needs are.

How many years were you in foster care?

In what state(s) were you in foster care?

Do you have contact information for your case worker?

Yes No

Do you have a reliable form of transportation?

Yes No Maybe

Do you have any immediate medical needs?

Yes No Maybe

If you answered yes or maybe to the above question, please explain.

Do you have any mental health diagnosis?

Yes No Maybe

Are you currently seeing a counselor or therapist?

Yes No

Do you have any current commitments? (work, school, treatment program, etc)

Yes No Other

Do you have any children living with you?

Yes No

Have you graduated High School?

Yes No

Unfaulted's Commitment

We are committed to work with you to build a foundation for a successful future. We commit to walk alongside you in this journey. Upon acceptance into Unfaulted, you will be asked to review and sign our Participation Contract.

Please list 1 trusted adult, mentor or therapist we can contact as a referral. Include their email and/or phone number.

I affirm the information contained herein is true and accurate to the best of my knowledge and belief. Please sign:

I understand I am not automatically accepted into Unfaulted by filling out this application. By completing and submitting this application I am moving forward with the application process which will include an interview, virtual psychological evaluation and drug test. *

I understand