2018-19 Academic Year
CTWS Tribal Education Loan/Grant Program Application for
Financial Assistance-Tribal Scholarship
Student Information (Please type or print clearly)
CTWS Tribal Member Name: / Maiden Name / Social SecurityMailing Address / PO Box / CTWS Tribal Enrollment #
Date of Birth
E-Mail / Phone #
Tribal Scholarship REQUIRES a High School Diploma or GED
Name of High School Graduated from: / Madras High SchoolSubmit/Attach High School Diploma: yes no / Submit/Attach High School Official Transcripts: yes no
GED Submit/Attach copy of GED Certificate: yes no / Submit/Attach GED test scores: yes no
College/University (plan on attending)
Name of College or University you plan on attending:Major: / Did you know CTWS scholarship does not fund minors:
Date of Acceptance: / Projected Graduation date:
Seeking type of Degree: Associates of Bachelors of Masters of Vocational short term long term
Payment Purpose: 1st day of class: ___ Fall ___Winter ___Spring __Quarters (or) __Semesters
Continuing/Returning Students: List all College’s/Universities attended.
Names of College/University / Dates of Attendance / Office Use: If Graduated copy of diploma/Off. Tran. On fileMUST Attach Official Transcripts from college’s you’ve attended submit BY JULY 1st
OFFICE USE ONLYATTACHMENTS / ATTACHMENTS / ATTACHMENTS / ATTACHMENTS / 2018 / Programs
CTWS TM #
HS Diploma
HS Transcripts
GED
FAFSA Confirm.
FAFSA Award
CTWS NAS
5 Other Scholarship / T/S/Application / Acceptance Letter
Degree list
Transfer Evaluat.
Or DAR’s
PEP appt
Every Qtr./Sem.
Grades
Registration
Acct. Summary / Employed yes/no
Supv. Signt.
Drug Tested
Last working day
Full time students 20 hrs a week
Sub. copy check / Summer
Bridge – Below 100 level
Math
Writing
Reading / College University
Distance Learning
Masters/Graduate
Vocational Short/Long Term
Academic plan
Personal Letter
All Signed
Completed
College/University
Official Transcripts
1)
2)
3)
Tribal Scholarship Application
Date Faxed:
Date Received Original App.
Academic Plan:
Attach a degree checklist see your college catalog or advisor. The degree checklist will help you complete the following academic plan and to stay on track for graduation.
The CTWS SCHOLARSHIP GRANT/LOAN DOES NOT FUND MINORS
Associates Degree academic plan
FALL 2018 / WINTER 2019 / SPRING 2019Course # / Title / Cr. / Course # / Title / Cr. / Course # / Title / Cr.
Projected graduation date: , .
Bachelors Degree academic plan
FALL 2018 / WINTER 2019 / SPRING 2019Course # / Title / Cr. / Course # / Title / Cr. / Course # / Title / Cr.
Projected graduation date: , .
Graduate/Masters Degree academic plan
FALL 2018 / WINTER 2019 / SPRING 2019Course # / Title / Cr. / Course # / Title / Cr. / Course # / Title / Cr.
Projected graduation date: , .
Personal Statement on Educational and Career Goals: Outline your educational and career goals. Describe how you plan on accomplishing these goals, including steps you’ve taken to work towards these goals. State any relevant work experience and academic preparation you have experienced, including Student Success Strategies and SummerBridge. Letters of reference may be submitted.
Financial Information
Current Obligations:List Creditors and Amount (Mortgage, Car Payment, Car Insurance, Child Support, Etc.) / Resources:
List sources of income/awards (Veteran’s Benefits, Social Security, Savings, Trust Fund, Wages, Other, etc.)
$ / $
$ / $
$ / $
$ / $
$ / $
Yes I applied for FAFSA / Yes I submitted a copy of confirmation
Yes I will submit my FAFSA award letter before Sept. / Yes FAFSA eligible Not FAFSA eligible
If No or NOT eligible explain:
Free Application for Federal Student Aid (FAFSA)
Applied for Five Other ScholarshipsStudent/I have applied for the following scholarships
Date applied / Name of Other Scholarship applied to / Amount Awarded / Denied / Otherexample
00/00/0000 / COCC: / $3,000.00 / Divided into 3 quarters f/tuition
ATTACH SUPPORTING DOCUMENTS FOR YOUR FILE
Tribal Scholarship Application Release of Information – Tribal
Permission is granted to the Higher Education Department to:
1)Obtain information from my official school/college records that may be requested, which includes grade reports transcripts of my academic records or general information with the college/institution regarding my educational status.
2)Print my name in the tribal local newspaper/newsletter and on a published master Graduate Listing.
3)Provide a report on Student Name/Major/Name of College to Supervisor, S/T, COO,Education Committee and Tribal Council.
4)Provide listing report to Credit, Human Resources, Comp & Benefits, and I.H.S.-Health & Wellness Center.
5)To release information/documents/check to my
Parents, Guardian, Spouse or Other-please print nameSignature/type in name:
Tribal Scholarship Application Employment Information:
I am a full time student / Part-time student / Number of JobsI’m employed: Yes No / Employed full time / Employed part time
Job 1 / Job 2 / Job 3
Place : / Place: / Place:
Phone: / Phone: / Phone:
Supervisor Signature / Supervisor Signature / Supervisor Signature
Last working day: / Last working day: / Last working day:
Continued Employment Information: Permission is granted to Higher Education Department to contact my supervisors and I understand as a FULL time student I have read the CTWS Tribal Scholarship guidelines Page 4, Section XXII. Employment on Full-Time Students can work up to 20 hours a week and submit copies of paycheck stubs to Higher Education. (Online: by typing in your name mean you will maintain tribal scholarship guidelines/requirements.
Student Signature/Type in: / Date:
Tribal Scholarship Application Release of Information – College/University
Full Name (Print/Type): / Social Security#I Hereby Authorize Registrar’s Office of:
To Release information to The Confederated Tribes of Warm Springs, Higher Education, PO Box, Warm Springs, Oregon 97761, information that may be requested includes: grade report, official transcripts of my academic record, financial information and other information deemed necessary. Student’s Signature and Date:
Name:
Social Security # / Tribal Enrollment #
Agreement
1. I received a copy of the guidelines governing the Tribal Educational Loan/Grant Program and agree to follow such guidelines as I pursue my higher education degree. In accepting funding from the Tribal Educational Loan/Grant Program’s scholarship fund, I agree to join in a partnership with the Confederated Tribes of Warm Springs Higher Education and will follow the rules governing the program.
2. I understand that as a Tribal Scholarship recipient, I am required to meet Tribal Minimum Academic Standards each term of study.
3. I understand that I will be placed on academic probation if I fail to meet Tribal Minimum Academic Standards in a given term and will be required to submit a grade report before following term’s scholarship will be processed.
4. I understand that if I fail to maintain Tribal minimum academic standards while on probation, I will be suspended from the educational program and will be required meet with Higher Education to determine my future status with the Tribal Educational Grant Program.
5. I agree to meet with Higher Education a minimum of three times an academic school year to update records and discuss changes and progress.
6. I agree to provide the Higher Education Department a copy of my grade report at the end of each term of study. I further agree to provide a full official transcriptor E-Transcript at the completion of Spring Term. Failure to do so will result in a delay or suspension of subsequent awards and will affect Student Trainee eligibility. (Official Transcript: Sent directly to Higher Education Department from Registrar’s Office.)
7. I agree to repay the Higher Education Scholarship Fund for any and all monies advanced to me in the event that it is determined that I am obligated to, due to failure to complete a college/vocational program. I understand that the Accounts Receivables policies of the Confederated Tribes govern repayment of delinquent accounts.
8. By typing your name in throughout the application you agree to the tribal scholarship agreement and guidelines.
**Note: Any student with 0 credits and 0.00 GPA will be automatically suspended from the Warm Springs Tribal Educational Loan/Grant Program and is required to meet with Higher Education to discuss status, regaining eligibility, and repayment. ______Student’s Initials
Signature: / Date:Applications: Applying online, typing in your name on application means you will follow/maintain tribal scholarship guidelines requirements.
Annual Tribal Scholarship Application Deadline Date is July 1st NEW Early Bird application due May 1st / 1