EDUCATION HOUSING ASSISTANCE APPLICATION - Native Village of Napaimute

TRIBAL MEMBERS GOING TO POST SECONDARY SCHOOL OR TRAINING MAY BE ELIGIBLE FOR UP TO $1,250 PER SEMESTER FOR HOUSING. PRINT & FILL OUT THIS APPLICATION. INCLUDE YOUR MOST RECENT TAX RETURN, PROOF OF ENROLLMENT, & LEASE GREEMENT / HOUSING RATES. RETURN TO THE NAPAIMUTE TRADITIONAL COUNCIL OFFICE. SCAN & EMAIL FOR FASTER PROCESSING

NVN Post–Secondary Education Housing Assistance Grant

Tribal Member Verification:

I certify that the applicant, __________________, is a tribal member of the Native Village of Napaimute, a federally recognized tribe.

Applicant’s enrollment #:__________________

____________________ ________________
President Date

Income Verification:

I certify that the family income for the applicant, _______________________, was verified as follows:

The applicant is: O Income eligible

O Not income eligible

Verification Used: O Copy of Tax Return: Year ______ (attached)

O Other: Specify: ______________________ (attached)

_____________________ ________________
President Date

Post-Secondary Institution Verification:

Name & Address of Institution: _____________________________________
_____________________________________
Full-time Student: O Yes
O No

Admissions Office Phone:_____________

Living: O On Campus: Housing Office Phone:_____________(attach housing
O Off-campus: Landlord’s Phone:________________ rates)

Amount Requested: $_________________

________________________ ________________
Tribal Administrator Date

Created By mleary on 09/29/2009 08:11 PM
Last updated by mleary on 09/29/2009 08:23 PM

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