EDUCATION HOUSING ASSISTANCE APPLICATION
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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