CITC Scholarship Application I am a new student only who has never applied before or last applied over 3 years ago. If you are a new student please provide a copy of your GED or Fall 2015 Application Deadline: Final High School Transcripts I am a continuing student who last applied within three (3) years or I applied for the Spring 2015 scholarship award. Personal Information Student Name: (First, Middle Name, Last) Gender: Male Female Home (permanent) address: Other Full Names Used: Date of Birth: Social Security #: Mailing Address: Same as Home address Work Phone: Cell Phone: Email Address: School Email Address: Academic Information Classification Year May 31, 2015 Applications accepted by email, fax, postal service, or by scheduled appointment. Freshman (0-29 credits) Senior (95+ credits) Home Phone: Sophomore (30-59 credits) Graduate Junior (60-94 credits) Field of Study / Name of Degree: Transcripts and Credits I am going to school: Begin Date: _____________ End Date: ______________ Fall Spring Summer Part Time Full Time (Mo/Yr) (Mo/Yr) (6+ credits) (12+ credits) Graduation Date: _______________ (month/day/year) Eligibility My Regional ANCSA Corporation(s) is: Ahtna Aleut ASRC BSNC BBNC Calista Chugach (Check all that apply) CIRI Doyon Koniag NANA Sealaska 13th Region Other I am an Alaska Native Shareholder or Descendant I am a Tribal member of the following Cook Inlet Region village: Chickaloon Tyonek Ninilchik Kenaitze Knik Salamatof None: Financial Aid Information Name of school you are attending/enrolled in: Financial Aid Office: (Mailing Address, City, State, Zip) Financial Aid Counselor: Financial Aid Telephone: Financial Aid Counselor’s Email Address: Financial Aid Fax: I am receiving other Scholarships Yes If Yes, please list which scholarships: Education Status Financial Aid Website Address: No Name of School Degree: Date: Secondary Education I understand that by signing below, I certify the information is true, correct and complete to the best of my knowledge. I understand that any deliberate false statements are subject to grounds for immediate withdrawal of my application. Student Legal Name: Student Signature: Social Security Number: Date: For application questions or assistance, please schedule an appointment by contacting scholarships@citci.org or 907-793-3263. Cook Inlet Tribal Council, Inc. 907-793-3466 Fax ATTN: Scholarships 3600 San Jeronimo Drive, 4th Floor Reception http://citci.org/education/scholarships/ Anchorage, AK 99508 ~ Updated as of 4/27/15~ ~ For Office Use Only – Dates Stamp Area ~ CITC Scholarship Application Scholarship Documents Fall 2015 (THE) Tribal Higher Education Scholarship Checklist Completed and signed application Proof of Alaska Native/American Indian (AN/AI) Blood or Certificate Degree of Indian Blood (CIB/CDIB) or Proof of Tribal Enrollment CIRI Documentation (CIRI shareholder or direct lineal descendent documentation) CITC Authorization to Obtain Personal Information CITC Authorization to Release Personal Information from CITC CITC Authorization to Obtain/Release Personal Information Within CITC CITC Intake Form (new scholarship applicants and/or change in personal information) CITC Client Grievance Policy & Client Acknowledgement Statement Official Transcripts noting cumulative GPA (THE - must maintain a minimum cumulative GPA of 2.0) Acceptance Letter or Academic Program Change Other funding sources Cook Inlet Region Tribal Affiliation Relevant Award Letters and/or Denial letter for Tribal funding Reference Letter (from a non-family member) Current Class Schedule Budget Forecast (available from your school) Student Aid Report (SAR) –obtain free from Federal Application for Student Aid (FAFSA) (If you are not filling out a FAFSA, please complete the attached Financial Disclosure Form.) Proof of Selective Service Registration (male students 18-25 years of age) For application questions or assistance, please schedule an appointment by contacting scholarships@citci.org or 907-793-3263. Cook Inlet Tribal Council, Inc. 907-793-3466 Fax ATTN: Scholarships 3600 San Jeronimo Drive, 4th Floor Reception http://citci.org/education/scholarships/ Anchorage, AK 99508 ~ Updated as of 4/27/15~ ~ For Office Use Only – Dates Stamp Area ~ CITC Scholarship Application Scholarship Documents Fall 2015 (AM) Alyeska Match Scholarship Checklist Completed and signed application Proof of Alaska Native (AN) Blood or Certificate Degree of Indian Blood (CIB/CDIB) or Proof of Tribal Enrollment AM Student Information Release & Attestation Applicant EEO Student Resume Official Transcripts noting cumulative GPA (AM - must maintain a minimum cumulative GPA of 2.5) Degree/Certification program curriculum & completion dates Personal statement of career goals/statement of purpose Other funding sources (notice of other scholarships (not CITC), or funding from any other Alyeska sources (i.e. Internships, scholarships) Based on the Grant file these are the eligible career fields Engineering: Electrical, Mechanical, Civil, chemical/Process Business: Management Information Systems, Technology, Engineering Management, Environmental Quality Engineering/Science, Project management, Construction Management, Project Controls Environment: Biology, Chemistry Planner / Scheduler: Accounting, Finance, Economics, Math/Statistics – Engineer Majors Quality Assurance / Inspection Professionals / Project Managers: Please see Engineering, Safety, and Business Majors Technical: Process Technology, SCADA, Instrument, Welding For application questions or assistance, please schedule an appointment by contacting scholarships@citci.org or 907-793-3263. Cook Inlet Tribal Council, Inc. 907-793-3466 Fax ATTN: Scholarships 3600 San Jeronimo Drive, 4th Floor Reception http://citci.org/education/scholarships/ Anchorage, AK 99508 ~ Updated as of 4/27/15~ ~ For Office Use Only – Dates Stamp Area ~ CITC Scholarship Application Document Descriptions and Forms for Tribal Higher Education Scholarship (THE) Proof of Alaska Native/American Indian (AN/AI) Blood – Available from the Bureau of Indian Affairs (BIA) office at http://www.bia.gov/WhoWeAre/RegionalOffices/Alaska/ This can be in the form of your Certificate Degree of Indian Blood (CDIB or CIB) or Tribal Enrollment Documentation if that document verifies that you are AN/AI. Only 1st time applicants need to submit. CIRI documentation – Documentation that you are an original enrollee, or direct lineal descendent of an original enrollee in Cook Inlet Region Incorporated (CIRI) – Available from CIRI Shareholder Relations: (907) 263-5191, toll free (800) 764-2474, or via email at shareholderrecords@ciri.com. Please note, we can either accept a CIRI enrollee card, a enrollee descendent card, or a letter from shareholder relations certifying your status. As another option, you can demonstrate your descendent status by showing the original shareholder's CIRI enrollment card and a document, such as your birth certificate or marriage certificate that shows that you are the shareholder's descendant. Only 1st time applicants need to submit. Release of Information forms o CITC Authorization to Obtain Personal Information o CITC Authorization to Release Personal Information from CITC o CITC Authorization to Obtain/Release Personal Information within CITC CITC Intake Form – Only need to submit if you are a new applicant, or have changes in your personal information since last submitted. Client Grievance Policy Acknowledgement Statement Official Transcript/Most current official transcript noting cumulative GPA (you must have and maintain a minimum cumulative GPA of 2.0 to apply and be eligible for the Tribal Higher Education Scholarship) – Available from your school’s office of the registrar. If you cannot supply an official transcript, we can accept a version printed from your school's on-line system if it is signed and witnessed in person by a CITC employee. If college transcripts are not yet applicable, high school transcripts may be provided. College Acceptance letter or Academic Program Change – Letter from your school granting you admission; proof of admission or program change. Other funding sources – need to provide notice of other scholarships. Cook Inlet Region Tribal Affiliation Award/Denial letter for tribal funding – Applicants who are enrolled in a Cook Inlet region Tribe (Chickaloon, Eklutna, Kenaitze, Knik, Ninilchik, Salamatof, Seldovia, or Tyonek) must apply for that Tribe's scholarship program prior to applying for CITC's scholarship. You will only be eligible for the CITC scholarship if you are denied by the tribe you are enrolled in. You need to provide verification of the denial of the scholarship funding from your Tribe in order to be eligible for CITC funding. -Continued on next page For application questions or assistance, please schedule an appointment by contacting scholarships@citci.org or 907-793-3263. Cook Inlet Tribal Council, Inc. 907-793-3466 Fax ATTN: Scholarships 3600 San Jeronimo Drive, 4th Floor Reception http://citci.org/education/scholarships/ Anchorage, AK 99508 ~ Updated as of 4/27/15~ ~ For Office Use Only – Dates Stamp Area ~ CITC Scholarship Application Reference letter from a non-family member – Letter recommending you as a good candidate for college, with the skills and desire to complete your degree program and college goals. This can be from a teacher, counselor, supervisor or any non-relative who can speak to your academic potential. For your reference, see the sample letter below. Sample letter of recommendation To Whom It May Concern: I have known Your Name for the past two and a half years, having served as her teacher in both English and Arts at ________ High School. I believe that Your Name is very well suited for higher education. Your Name is a bright and attentive young person. In class and in her work, she demonstrates that she is an intelligent and capable student with great potential. I am confident that she will thrive in any academic program that she chooses to pursue. I am convinced that Your Name would make a more than valuable contribution to your university. She has my highest recommendation. Should you have any questions, please do not hesitate to contact me. Sincerely, Name of Non-Relative Teacher, _______ High School Current class schedule – Available from your school’s office of the registrar or via your online student portal. Budget Forecast - Available from your school’s financial aid office or via your online student portal. This may also be called Financial Need Sheet, Cost Information Sheet, or Statement of Student Account. At a minimum, your budget forecast needs to show the cost of your academic program (tuition, fees, books, room and board) and your other sources of income (other scholarships, loans, parental support, etc.) Student Aid Report (SAR) obtain free from Federal Application for Student Aid (FAFSA). You must apply for financial aid through the FAFSA program to be eligible. This will result in a SAR. Your SAR is viewable by clicking Login on the FAFSA on the Web home page. Next select either the PDF or HTML version of the SAR from the “My FAFSA” page: https://fafsa.ed.gov/. If you are not filling out a FAFSA, please complete the Financial Disclosure Form Proof of Selective Service registration – required for male applicants between the ages of 18-25. Available here: https://www.sss.gov/regver/wfverification.aspx For application questions or assistance, please schedule an appointment by contacting scholarships@citci.org or 907-793-3263. Cook Inlet Tribal Council, Inc. 907-793-3466 Fax ATTN: Scholarships 3600 San Jeronimo Drive, 4th Floor Reception http://citci.org/education/scholarships/ Anchorage, AK 99508 ~ Updated as of 4/27/15~ ~ For Office Use Only – Dates Stamp Area ~ CITC Scholarship Application Document Descriptions and Forms for Alyeska Match Scholarship (AM) Proof of Alaska Native (AN) Blood – Available from the Bureau of Indian Affairs (BIA) office at http://www.bia.gov/WhoWeAre/RegionalOffices/Alaska/ This can be in the form of your Certificate Degree of Indian Blood (CDIB or CIB) or Tribal Enrollment Documentation if that document verifies that you are AN. Only 1st time applicants need to submit. Alyeska Student Information Release & Attestation Alyeska Applicant EEO Current Student Resume Document briefly outlining work and academic skills and experiences Official Transcript/Most current official transcript noting cumulative GPA (you must have and maintain a minimum cumulative GPA of 2.5 to apply and be eligible for the Alyeska Match Scholarship) – Available from your school’s office of the registrar. If you cannot supply an official transcript, we can accept a version printed from your school's on-line system if it is signed and witnessed in person by a CITC employee. If college transcripts are not yet applicable, high school transcripts may be provided. Degree/Certification program curriculum and estimated completion dates –Outline or certification of program curriculum and graduation dates. Available from your school’s administration, usually the office of the registrar, or through your on-line student portal. Personal statement of career goals/Statement of Purpose – 250-300 word statement identifying your professional goals. Other funding sources – need to provide notice of other scholarships or funding (not CITC), or from any other Alyeska sources (i.e. Internships, scholarships). For application questions or assistance, please schedule an appointment by contacting scholarships@citci.org or 907-793-3263. Cook Inlet Tribal Council, Inc. 907-793-3466 Fax ATTN: Scholarships 3600 San Jeronimo Drive, 4th Floor Reception http://citci.org/education/scholarships/ Anchorage, AK 99508 ~ Updated as of 4/27/15~ ~ For Office Use Only – Dates Stamp Area ~
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