The University of Tennessee at Chattanooga Mosaic Program
APPLICATION FOR ACADEMIC YEAR 2021-2022
BEFORE YOU BEGIN: Please note that this application must be completed in one sitting. There is no option to save and return. We recommend that you review the application before starting to ensure that you have the necessary information.
All of the following information must be submitted by Friday, January 15th, 2020@ 3:00pm (Eastern Time):
1) Completed Mosaic Program application
2) Copy of UTC acceptance letter or proof that you have applied (i.e. email confirmation from UTC that your application has been received)
3) Documented evidence of an Autism Spectrum Diagnosis. This documentation should be in the form of a Clinical Psychological Report or Psychoeducational Evaluation performed by a qualified and licensed professional. This information will help us in establishing a diagnosis of Autism and how it may impact you. It will also allow us to make an informed decision about your readiness and fit for the Mosaic Program.
4) A copy of your high school transcripts. For students who have previous college experience: an unofficial transcript from that institution, or other documents that detail classes taken and grades earned.
5) If applicable, history of supports used in the high school setting (Ex. IEP). If you utilized accommodations in a college setting please include those as well.
6) The names and contact information of two references. One must have worked with you in an academic setting and the other reference should be a another professional who has worked with you and knows you well (ex. mental health professional)
If you need to submit a paper version of the Mosaic application, we are able to make that accommodation. Please email firstname.lastname@example.org