Oglala Sioux TribeHigher Education Grant Program

P.O. Box 562Pine Ridge, SD 57770-0562

(605)&67-533& * 1-&00-&32-3651F1tx (60j)861·Ll90 ' Email-nigheredln>.gwtc.net

INSTRUCTIONS FOR ALL APPLICANTS(PLEASE READ .UL INSTRUCTIONS CAREFULL Y TO ELL\[INA TE DEL\. YS)

*Documents must be submitted by the deadline date listed below (or the termts) you are applying Cor.*All awards are based on first come first serve; your file must be complete before review.*Awards are contingent upon academic progress, financial need and availability of funds.

_____ APPLICATION FORi\{ - to be entirely completed by you, the applicant.

__ CERTIFICATE OF INDIAN BLOOD DEGREE - showing that you are an "enrolled" member of theOglala Sioux Tribe.

__ LETTER OF ACCEPTANCE OR OPEN DOOR POLICY VERIFICATION - from the collegeyou will attend (submit once unless you transfer from one college to another).

__ FINANCIAL AID NEEDS ANALYSIS FORi\tI ~ please complete the top portion of this form beforeyou send it to the financial aid office. This form must be completed by your institutions financial aid

. office, and then sent back to the OST Higher Education office. ,This form is attached to this application.

__ COLLEGE TRANSCRIPT'S} OR ()FFICM G~:E: REPORT - for aIL continuing and formerstudents that have received an OST Higher Education Grant award. Transcripttsj/Reports must reflectminimum.requirements (12 hrs. w/2.00 GPA).

__ SUMMER APPLICANTS - must submit an of the above as well as a 'written justification for summerroncimg;

FOLLOW UP ON ALL OF YOUR PAPERWORK - it is your responsibility to ensure all necessarydocuments are submitted by the deadline date to complete your file.

***:f::I'~'.!!~~t.!:.t!*DEADLINE DATES***************

NNE 15th - ACADEMfC YEAR (includes Fall & Winter Quarters; Fall Trimester)

NOV~MBER 15th- SPRING TERl'v1 ONLY (includes Spring Quarter; Spring Trimester)

APRIL ISI - ALL-SUM1'v1ER SESSIONS

ALL FILES l'YruST BE COlYfPLETE BEFORE REVIEW, applicants must also meet all other eligibilitycriteria.

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O.S.T. Higher Education Grant ApplicationOglala Sioux Tribe

Higher Education Grant ProgramP.O. Box 562

Pine Ridge. SD 57770-0562(605) S6;-5:i38 • 1·800·832·3651 • Fax - (605)-867-lJ90 • Email-hi2h~rcd((I>.~wtc.nc!

*** APPLICANT INFORMATION ***Please complete entire application

APPUCA TION FOR: Academic Year 20 to 20 SUMMER SESSION(S) 20 _

Winter Only 20__ Spring Only 20 __Fall Only 20__ .

Last Name Maiden SSNFirst Name MI

Address Telephone Evmail AddressCity State/Zip

o Male o Female / / # of Dependents: _0.0.8. Marital Status:

Contact Person(spouse): _

Graduation Date & Where: _

[f so, when: _

[fyes, where: _

High School Graduate: G.E.D. Graduate:

Have you ever applied for a Higher Education Grant: ISJ ~DYes DNoEmployed:

Other source of income: --------------------------------------(SSl, Soc. Sec., TANF, etc ... )

College/University attending: _

Address: .-=~~~~====~~~----------------City/State/Zip: _

_2 Yr. College _4 Yr. College

Telephone: _

Academic Level:(Year in College)

___ 33-64 Hrs.Sophomore

____ 65-97 Hrs. ___ 98+ Hrs.___ 1-32 Hrs.Freshman Junior Senior

Type of Degree you plan to receive:College Major: _

Starting Term: _

Expected Graduation Date: _

A.S.

B.S.

A.A.S.

B.F.A.

AA.

BA

__ 2 Yr. Degree __ 4 Yr. Degree

~tatement of Certification and Consent for RELEASE OF INFORtvlATIONj

I hereby certify that the above information on this form is true and correct to the best of my knowledge and consent to the release of this information tonecessary agencies to complete my financial aid package. I understand thar any granr awarded to me will be in care of the financial aid office at thecollege/university. Iwill provide an Official Grade Report or Official College Transcript to the OS.T. Higher Education Grant Program at the end or eachterm. Ideclare that [ will use any funds Ireceive under the OST Higher Education Grant Program IOldy for expenses connected with attendance at thiscollege/universtry.

Applicant Signature Dale

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.k?JaJaSioLL,(TribeHigher Education Grant Program

r.o. Box 562Pine Ridge, SD 57770·0562

(605) 867 ·5]38 • 1·800·832·3651 • Fax - (605)867·1390' Email- highcr~ut7ihvtc.nt:{

e.

, " FIN~~NCIAL AID NEEDS ANALYSIS FORlYI

1* APPLICANT INFORl'rIATION *1

Last Name First Name MI Maiden SSN

Address City State/Zip Telephone E-mail Address

ITa BE COMPLETED BY THE FINANCIAL AID ADMINISTRATOR]

Applicants Academic Level: oConwunity College 02 Yr Institution 04 Yr Institution

Name of Institution: ----------------------------------------------Address: -----------------------------------------------------City/State/Zip: _

Telephone: _

This applicant plans to attend the following term(s):

DFall Semester/Trimester 0 Spring Semester/Trimester 0 Fall!Wintcr Quarter oSpring Quarter c::J Summer Session(s)

Budget Period from 20Applicant is ineligible for PELL due to: _

to 20------------- ---

·-Atte~-d~-ii~~=c()sT8~d'gifFRe-s'ources & oiherAid: Federal Aid:Tuition s Parent Contribution S F.W.S. sAll Fees $ Student Contribution s PELL Grant sBooks/Supplies S Tuition Waiver S Perkins SRoom/Board s veteran Assistant S Plus Loan sTransportation S Voc. Rehab. S F.S.E.O.G. sPersonal Care S Off Campus Scholarship S Stafford Loan sChild Care S State Indian Grant s Stafford UnSub. $ .

~l~.~~:§x,p~nse S. College/University Grant s CollegeJUniversityloan SOther $ CollegeJUniversityScholarship s S.L.S. s

Other s Direct T. A. S

Total Cost: $ Total Resources & Aid: $ Total Federal Aid: $

The applicant's unmet need shall be determined by subtracting the total resources and total federal aid from the cost of attendance.

I) This applicant has a zero financial aid need at this institution: Yes No

2) Recommendation for OST Grant Award amount: oS -----------------

DateSignature of Financial Aid Administrator

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