APICDA Student Loan Repayment Program

Transcription

1 APICDA Student Loan Repayment Program APICDA s Student Loan Repayment Program repays a specific dollar amount of a graduate s student loans as long as the graduate meets program requirements. This program was created to encourage graduates of the APICDA Region to return for employment and career opportunities. APICDA accepts Student Loan Repayment applications from applicants who have graduated with an associate s, bachelor s or post graduate degree and who are from one of the APICDA Region communities, 1 / or who qualify through historical ties. 2 / An applicant must have received a student loan from an authorized lending institution, obtained a degree, and either be employed or have secured employment in the APICDA region, or with an entity that directly serves the APICDA region, within 6 months after graduation. Employment may be full-time or part-time, and may not be temporary. A recipient may receive up to $5,000 per year paid directly to the lender by APICDA on behalf of the recipient, due over a five-year period or until the graduate ceases his or her qualifying employment. No graduate will receive more than $5,000 per year or more than a total of $25,000 over the course of the loan repayment period. A recipient who qualifies for this program through residency in an APICDA Region community must notify APICDA immediately upon leaving the APICDA Region community and must submit a quarterly Statement of Residency and proof of employment. For an applicant or recipient whose qualifying employment is in the APICDA Region, rather than for an entity that benefits the region, an absence of more than 90 days in a calendar year from the APICDA Region disqualifies from repayment. Excused absences for more than 90 days are military duty, medical requirements, and higher education. All excused absences require proper documentation. Payments under this program may be subject to federal income tax. APICDA will issue the recipient and the IRS a Form 1099 annually, as required by law. Taxes are the sole responsibility of the recipient. The program s effective date is 1/1/14. The program applies to graduates who were enrolled 1/1/13 or later in a degree program. 1 / An applicant who claims qualification for this program by residency in an APICDA Region Community has resided full-time in the community for at least the five years immediately before application and demonstrably intends to return to (or work for the benefit of) the APICDA Region upon award of a degree. 2 / Eligible applicants may be Native or non-native, but must live in, or show historical ties to, one of the following communities: Akutan, Atka, False Pass, Nelson Lagoon, Nikolski, St. George, or Unalaska.

2 APICDA A Completed Application Includes: (Please check off) Proof of residency in, or proof of historical ties to, one of the following communities: Atka Akutan False Pass Nelson Lagoon Nikolski St. George Unalaska All pages of this application form, completed and signed Copy of diploma demonstrating graduation with associate s, bachelor s, or postgraduate degree Copy of official transcript from associate s, bachelor s, or post-graduate program Documentation of student loan(s) corresponding to associate s, bachelor s, or postgraduate degree, including current student loan statement Proof of in-region employment or work for the benefit of the APICDA region Completed Verification of Residency Completed Statement of Residency Two letters of recommendation: 1. Professional (school- or work-related) 2. Personal Essay or letter of interest that includes: 1. Brief personal history 2. Career goals 3. How degree has helped to achieve these goals 4. Why the applicant should be selected for a student loan repayment award Completed release of information form Current Resume

3 APPLICANT INFORMATION: First Name: Last Name: SSN: Date of Birth: Current Address: City: State: Zip: Phone: Cell: Current Employer: Your Title: Supervisor s Name: Employer s Phone: Employment start date: Current Community and State of Residency: Address: High School Attended: Graduation Date: College/University Attended: Graduation Date: Degree: Associate s Bachelor s Master s Doctorate Cumulative GPA: Where did you live before pursuing your degree? How long? Are you a past recipient of the Emil Berikoff Sr. Memorial Scholarship? Yes No If Yes, When? Are you a past recipient of any of APICDA s funding programs? Yes No If Yes, when? Which program(s)?

4 Did you take out student loans while attending college/university? Yes No Are you currently making payments on a student loan? Yes No Name of Students Loan/Financial Institution Interest Rate Amount Total References: Please list at least three references who are not related to you and are able to verify your employment and residency status and historical ties. Name/Title Contact Information/Phone Number By signing this page and my attached letter, I certify: 1. My application, including but not limited to this form, my essay or letter of interest, and all other information and documents I provide in support of my application is my own original work. 2. I understand that if any aspect of my application is not my original work, it will be rejected and any award will be canceled. 3. All information I provide is true and correct. I understand that any intentional misrepresentation in my application will foreclose my participation now and hereafter in the Student Loan Repayment Program. Applicant s Signature: Date:

5 STATEMENT OF RESIDENCY Name: (Please print) Address: City/State: Zip: Social Security #: Phone: Fax: How long at this address? Date: No one may qualify for APICDA s Student Loan Repayment Program unless the applicant (1) is an APICDA community resident or (2) has demonstrated historical ties to an APICDA community. Definition of an APICDA community resident: An applicant must have maintained full-time residency in one of the APICDA communities for at least five years immediately before the application date, and must intend to return to (or work for the benefit of) the APICDA region upon award of a degree. To verify your residency in one of the seven APICDA communities, you must provide a Verification of Residency from an APICDA Community Liaison Officer (see attached form). In addition, you must provide an Alaska State-issued photo ID (driver s license or ID Card), and at least one of the following documents: A copy of your Permanent Fund Dividend check stub or deposit proof, for the most recent dividend year, that shows your current address; Copies of current utility receipts in your name, showing the address of your residence; A copy of your most recent paycheck stub that shows your residence address; A copy of your recent Temporary Assistance for Needy Families (TANF) or food stamps (SNAP) benefit receipts that shows your residence address; or A copy of your voter registration card showing your residence address. If you qualify for this program through residency in an APICDA Region community and you leave the community for any reason during the payment period, you must notify APICDA immediately of your absence and the reason for the absence. If you are out of the APICDA Region for more than 90 consecutive days for any reason, you must provide verification of excused absence. The only excusable absences of more than 90 days duration are: educational purposes, military service, or medical requirements. To qualify for a waiver of the 90-day requirement, you must supply at least one of the following: A copy of your school enrollment form or transcripts verifying full-time attendance during the previous year; or A copy of your current orders if you are on active military duty; or A letter from your treating physician stating that there is a medical reason you need to reside in another location, and the time estimated for that stay. By signing this Statement, I warrant that I am a resident of the APICDA Region community from which I am applying and I attest that the documents submitted are true and accurate to the best of my knowledge. I understand that any falsification or misrepresentation of the information submitted will result in the cancellation of benefits and I may be required to pay back any funds that were provided by APICDA as a result of the information provided. SIGNATURE: DATE:

6 VERIFICATION OF RESIDENCY It is a requirement of the Aleutian Pribilof Island Community Development Association that applicants for APICDA services be a resident of one of the 7 communities that APICDA represents, or in some instances demonstrate historical ties to one of the APICDA communities, An authorized Community Liaison Officer must complete this Verification of Residency. APICDA Communities: Akutan, Atka, False Pass, Nelson Lagoon, Nikolski, St. George, and Unalaska. Definition of a community resident: an applicant must have maintained full-time residency in one of the APICDA communities for at least five years immediately prior to the application date and must intend to return to (or work for the benefit of) the APICDA Region upon completion of school. I verify that: (Name) is is not A resident of, and has been has not been residing full-time in this APICDA community for the past five years. Signed by: Date: CLO of: If you have questions, please call APICDA at