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Driver's Education
Request for Driver's Education
DA Request for Driver's Education
Driver's Assistance Request for Driver's Education Please allow at least 3 weeks of processing time when submitting requests. Verification of program eligibility must be granted before funding can be achieved.
Your Relationship to Driver:
*
(Select the option that best describes your relationship with the participant.)
Self Request (Youth/Driver)
Caregiver
Social Worker
Tribal Case Manager
Independent Living Specialist / Case Manager
Treehouse Education Specialist
Treehouse Launch Success Coach
Treehouse Advocate
Your Name:
*
(Who is filling out this form?)
First
Last
Your Email:
*
(Please enter your email so that we can provide you with updates about your request.)
Participant's Name:
*
(Who needs payment assistance?)
First
Last
Participant's Date of Birth:
*
MM slash DD slash YYYY
Participant's Phone:
*
(If the participant does not have a personal phone, please input the number for the person who will have the most contact with them.)
Participant's Email:
*
(Must be participant's unique email address.)
Participant's Address:
*
(What is the driver's current address?)
Street Address
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Does the youth currently qualify as one of the following?:
*
(Participants must meet one of the following criteria to be eligible for Treehouse's Driver's Assistance program.)
Foster Care - Washington State Dependent
Foster Care - In-home Trial Return
Extended Foster Care - Foster to 21
Tribal Jurisdiction - Indian Child Welfare (ICW)
Participant's Tribal Association:
Confederated Tribes of the Chehalis Reservation
Confederated Tribes of the Colville Reservation
Confederated Tribes and Bands of the Yakama Nation
Cowlitz Indian Tribe
Hoh Indian Tribe
Jamestown S’Klallam Tribe
Kalispel Indian Community of the Kalispel Reservation
Lower Elwha Tribal Community
Lummi Tribe of the Lummi Reservation
Makah Indian Tribe of the Makah Indian Reservation
Muckleshoot Indian Tribe
Nisqually Indian Tribe
Nooksack Indian Tribe of Washington
Port Gamble S'Klallam Tribe
Puyallup Tribe of the Puyallup Reservation
Quileute Tribe of the Quileute Reservation
Quinault Indian Nation
Samish Indian Nation
Sauk-Suiattle Indian Tribe of Washington
Shoalwater Bay IndianTribe of the Shoalwater Bay Indian Reservation
Skokomish Indian Tribe
Snoqualmie Indian Tribe
Spokane Tribe of the Spokane Reservation
Squaxin Island Tribe of the Squaxin Island Reservation
Stillaguamish Tribe of Indians of Washington
Suquamish Indian Tribe of the Port Madison Reservation
Swinomish Indian Tribal Community
Tulalip Tribes of Washington
Upper Skagit Indian Tribe of Washington
Participant's Social Worker:
*
First
Last
Social Worker's Email:
*
Social Worker's Phone:
Participant's Tribal Contact:
*
First
Last
Tribal Contact Email:
*
Tribal Contact Phone:
*
Is the driver currently working with an Independent Living Specialist?:
*
Yes
No
Organization associated with Independent Living Specialist:
Catholic Charities
Volunteer of America
Olive Crest
YMCA
YWCA
Ignite
YouthNet NW
Pioneer Human Services
Pierce County Alliance
Name of Case Manager:
*
First
Last
Case Manager Email:
*
Case Manager Phone:
Caregiver's Name:
First
Last
Caregiver Phone:
Caregiver Email:
Caregiver's Address:
Street Address
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Is the driver currently enrolled at a driving school?:
*
If you have not enrolled and registered for driver’s education courses yet please be sure to sign up with an approved DOL driving school of your choice. Contact the driving school you’d like to attend and ask them to send an invoice to Treehouse’s Driver’s assistance program: licensing@treehouseforkids.org
Yes
No
Not Yet (waiting for Treehouse's funding approval)
Driver's Education Service Needed:
*
At this time Treehouse's Driver's Assistance program can provide up to $750 (per request) for the Driver's Education related services listed below. For more information please email us.
Driver's Ed Courses
Driver's Ed Down Payment/ Reservation Fee
Practice Sessions
Testing
Re-Testing
Missed Drive/ Cancellation Fee
What is the estimated start date for the Driver's Education Course?:
(Youth must be actively enrolled or have attempted to enroll in courses with the driving school listed on the request form)
MM slash DD slash YYYY
What is the estimated end date for the Driver's Education Course?:
MM slash DD slash YYYY
Are you seeking reimbursement for the requested service?:
*
Yes
No
Would you like your reimbursement by check or PayPal?
*
Check
PayPal
For PayPal reimbursement payments:
*
Please enter the name, email address, phone number or handle associated with the PayPal account.
Pay To:
*
Who should we send a check to?
Participant/ Youth
Caregiver/ Guardian
Case Manager/ Social Worker
Total Amount Paid:
*
(Driver's Assistance is able to provide a maximum of $750 for reimbursement of Driver's Education courses.)
Upload Receipt(s):
*
Please provide a receipt for services or items paid. Be sure this shows the date, participant name, total amount paid, and business/vendor name.
Drop files here or
Select files
Accepted file types: jpg, gif, png, pdf, Max. file size: 256 MB.
Does the driver have a Washington State I.D.?
*
Yes
No
Not Sure
Has the driver pre-applied online with the Dept. of Licensing for a state I.D.?
*
Yes
No
Not Sure
Does the driver have a current/valid Learner's Permit?
*
Yes
No
Not Sure
Has the driver pre-applied online with the Dept. of Licensing for a learner's permit?
*
(Driver's must have a learner's permit before they can practice driving.)
Yes
No
Not Sure
Participant's License Number:
(This is the driver's Washington State DOL PIC or WDL number found on the Identification card.)
Driving School Location:
*
(Participants and Care team must call the driving school and let them know Treehouse will be making a payment of up to $750, once the driver has been approved for funding.)
Not Listed
1st Avenue Driving School (Puyallup)
405 Driving School
911 Driving School - Bonney Lake
911 Driving School - East Wenatchee
911 Driving School - Everett
911 Driving School - Graham
911 Driving School - Kirkland
911 Driving School - Lacey
911 Driving School - Lakewood
911 Driving School - Lynnwood
911 Driving School - Marysville
911 Driving School - Mercer Island
911 Driving School - Port Orchard
911 Driving School - Puyallup
911 Driving School - Seattle
911 Driving School - Silverdale
911 Driving School - Spokane
911 Driving School - Tacoma
911 Driving School - Tumwater
911 Driving School -Kent
911 Driving School-Port Orchard
911 Driving School-Puyallup
A+ Driving School
A-1 School of Driving
ABC Driving School
Aberdeen All Star Driving School
Acme Driving School
All Seasons Driving School Inc
Aloha Driving School
B & B Driving School
B&B Driving School
Burien Driving Academy
Cascade Driving School
Cascade Driving School - Aberdeen
Cascade Driving School-Aberdeen
Central Washington Driving School
Confident Driving Instruction
Cowlitz Driving School
Cruiser's Driving Academy
Defensive Driving School - Arlington
Defensive Driving School - Kirkland
Defensive Driving School - Lake Stevens
Defensive Driving School - Poulsbo
Defensive Driving School -Bremerton
Defensive Driving School of Everett
Defensive Driving School of Kent
Defensive Driving School of Seattle
Diane's Driving School
Drivetech Driver Training - Graham
East Hill Driving School - Kent
Elite School of Driving
Exceleration Driving School
First Pass Driving School
Freedom Driving School - Tacoma/Spanaway
Freedom Driving School Lakewood
Freedom Driving School Puyallup
Inchelium High School (Inchelium)
Interface Driving Academy
Issaquah High School (vendor)
Lewis County Driving School
Monroe Driving School
Munros' Driving Instruction
Nelson Driving School
Northstar Driving Academy - Burien
Northstar Driving Academy (Covington)
Northstar Driving School (Auburn)
Northwest Driving School
On Target Driving School
PUGET SOUND DRIVING ACADEMY- DUVALL
Quality Driving School - Kennewick
Richardson's Safe Driving School
River of Life Fellowship
Road Scholar Driving School
Roadsafe Driving Academy
Safe2Go Driving School
Safety First Driving School
Sedro Woolley School District Traffic Safety Education
Service Alternatives - Spokane
Sonic Driving School
South Bend High School (South Bend)
South Sound Driving School
South Whidbey High School (South Whidbey)
Stanwood High School (Stanwood-Camano)
SWERVE DRIVING SCHOOL - Northgate
Top Gear Driving School
Volunteers of America
Wakes Driving School
Washington Driver Education Center 101 LLC
Washington Motorist Safety Training (WMST)
WMST Driving School & DOL License Testing Center
Xcelerate Driving School
Name of Driving School:
*
Driving School Phone:
Driving School Address:
Street Address
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Treehouse can provide limited financial assistance for the cost of travel to and from the driving school. Are you intersted in travel assistance?
Yes
No
Treehouse Driver's Assistance Release of Information
*
Driver’s Assistance is pleased to provide financial support for your driving goals. In order to successfully process payments and as a condition of enrollment, Treehouse requests permission to communicate, request, and exchange documents and details from/with your driving school during enrollment in the program. Please review and ensure that all the information entered above is correct.
I understand that Treehouse is only accessing information for the purpose of making payments and any data collected will be used solely for Treehouse's Driver’s Assistance Program.
I accept and agree to all of the above and that I have reviewed the information entered above and certify that all the above is correct.
We would love to hear from you!
Please indicate below if you are willing to receive one to two surveys over the next 6 to 12 months. Your participation helps us understand how we can better support youth experiencing foster care.
Yes, send me the surveys!
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