2016-2017 Other Funding Sources Worksheet

Western Dakota Tech

800 Mickelson Dr.

Rapid City, SD 57703-4018

PHONE: 605-394-4034 or 800-544-8765 FAX: 605-394-2204

2016-2017 OTHER FUNDING SOURCES WORKSHEET

You have indicated on your admissions application that you are a veteran, may have other funding sources, or both. Please complete the applicable sections below and submit the form to the financial aid administrator at WDT. If you have questions please contact us by phone at 605-394-4034 or 800-544-8765or by e-mail at

SECTION A: STUDENT INFORMATION

______XXX-XX-______

Western Dakota Tech ID-NumberSSN (Last Four Digits)

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First NameLast Name

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Mailing AddressCityStateZip

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Phone NumberCell PhoneEmail

SECTION B: OTHER FUNDING SOURCES

Please indicate if you are applying for, or will receive, any of the other resources listed below. Our office may need to complete additional information on your behalf for you to receive them. Failure to notify us may delay receipt of your funds.

If you are unsure of the amount you will receive pleaseindicate it’s an estimate. If you have applied for funding but are not sure you will receive it, please mark the amount as pending.If you need more room, please attach a sheet containing your name and student ID.

Place an (X) in front of each source for which you are applying, or will receive.
Funding Source / Dollar Amount
☐Chapter 16, 30, 31, 33 or 35 VA Benefits
☐National Guard Education
☐VA Vocational Rehabilitation
☐Vocational Rehabilitation
☐Bureau of Indian Affairs – Monthly Living Stipend
☐Bureau of Indian Affairs – Education Funding
☐Employer-Paid Benefits
☐Workforce Investment Act (WIA)
☐Outside scholarship*
☐Outside scholarship
☐Outside scholarship
☐Other
☐Other
☐Other
☐Other

*Scholarships from organizations other than WDT.

SECTION C: CERTIFICATION AND SIGNATURE

I certify that all of the information reported on thisworksheet is complete and correct. The student mustsign and date this worksheet.

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Print Student’s NameStudent’s ID Number

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Student’s SignatureDate

Submit this worksheet to the Financial Aid Office.

You may also scan and email this document to OR fax to605-394-2204.

Contact Information for Other Funding Sources

Veterans Administration (VA) and National Guard

Veterans and/or dependents of veterans who are disabled ordeceased may qualify for one of the programs of financial assistance for school purposes through the Veterans Administration. Contact the Veterans Administration Center, Box 5046, Sioux Falls, SD 57117 (toll free 1-800-827-1000) or students can also contact their local County Veterans Service office for more information (Veterans Service, Public Service Building, 725 North LaCrosse Street, Rapid City, SD 57701, (605) 394-2266). Members of the South Dakota National Guard may be eligible for National Guard educational benefits; students should contact their units to determine eligibility and certification procedures.

Vocational Rehabilitation

The Vocational Rehabilitation program is intended to assist those students with physical and/or mental disabilities to become active members of the labor market. The Service to the Visually Impaired is also a special section of the Division of Rehabilitation Services. It provides assistance to those individuals who experience some type of visual disability. Students who think they may qualify are encouraged to contact their local office of the South Dakota Division of Rehabilitation Services at 111-A New York St., Rapid City, SD 57701, (605) 394-2261.

Bureau of Indian Affairs (BIA)

The Employment Assistance Program of the Bureau of Indian Affairs assists diploma students who reside on or near the reservation to enroll in and pay for vocational education programs. Students must be of ¼ or more Native American descent. The student is expected to apply for other types of aid. The amount of this aid may be deducted from the eligible amount of Employment Assistance. Students must contact the BIA office for which they are registered for application materials and deadlines.

Workforce Investment Act (WIA)

The Workforce Investment Act of 1982 established a program to provide comprehensive services, which include the training, education, and other services needed to enable individuals to secure and retain employment. Eligible students may receive assistance in meeting direct school costs at WDT. Student are encouraged to contact the SD Career Services Office. In Rapid City, call (605) 394-2325.

Scholarships and Grants

It is through the generosity and kindness of many organizations that WDT is able to inform students of opportunities for funding their education. Scholarship amounts and deadlines vary, and funding for scholarships is purely voluntary ~ funding may increase and/or decrease from year to year. Please visit the scholarship page on WDT’s website at for a listing of available scholarships and applications.