Professional Agency Referral

Professional Agency

If you are the referring agency, please complete the form below.

Online Application

If you are an approved Referral Source, please complete the form below to recommend a candidate. Please ensure that the criteria below has been met.

• Must be referred by an approved referral source: guidance counselor, case manager, behavioral health/social professional, crisis center or pastor


• Requires one (1) Character Reference Letter


• Must be a high school senior or college student between the age of 17-25* that has lost one or both parents to domestic violence OR


• Must be a single person between 17-25 who is a survivor of domestic violence OR


• A single parent who is a survivor of domestic violence between the ages of 17-35


• Must be enrolled at an accredited technical school, college or university


• Must provide proof of enrollment in a certificate, technical, associate, undergraduate or graduate program


• Must be a US citizen AND resident of Oklahoma or Virginia


• Minimum GPA requirement of 2.5


• No violent criminal history



Please note: High School Seniors under the age of 17 may apply*


The ultimate goal is to empower these individuals to become self-sufficient and independent through education. We firmly believe that education
leads to better opportunities for individuals and their families.