Applicatins are due t the Cuncil pstmarked by February 1. Applicatin Infrmatin Sheet Read the entire infrmatin sheet befre cmpleting the applicatin. Print a cpy f this sheet fr yur recrds. What is the American Indian (AIES) prgram? This prgram prvides educatinal schlarships n a cmpetitive basis t utstanding students with clse scial and cultural ties t an American Indian tribe r cmmunity in the state. Recipients are selected n the basis f academic merit and a cmmitment t serve the American Indian cmmunity in the state f Washingtn. Schlarships are awarded frm the interest earnings f an endwment established frm funds apprpriated by the Washingtn State Legislature with matching cntributins frm tribes, private individuals, and rganizatins. Wh is eligible t apply? Yu must: Have clse scial and cultural ties t an American Indian tribe, r an American Indian cmmunity, in this state. Intend t use yur educatin t benefit ther American Indians in Washingtn state. Have demnstrated financial need (as determined by the cllege financial aid ffice). Be a Washingtn state resident. [See Chapter 250-18 Washingtn Administrative Cde (WAC)] Be enrlled as a full-time student at an eligible Washingtn cllege r university by fall term f the award year. Nt be pursuing a degree in thelgy. Have received fewer than five years f this schlarship, in ttal. Hw d I apply fr the schlarship? Cmplete the attached applicatin frm, which requires Adbe Acrbat Reader sftware, versin 10.0 r newer. The sftware is available fr free dwnlad at www.adbe.cm. A hard cpy must be printed fr signature and mailing. Renewal applicants must have Sectin V cmpleted by their academic dean, department head, r advisr. Attach a detailed statement describing yur clse scial and cultural ties t an American Indian cmmunity in state. If yur riginal ties are t an ut-f-state tribal cmmunity, als describe hw yu have established clse scial and cultural ties t the American Indian cmmunity in Washingtn state. Attach a statement describing hw yu intend t serve the American Indian cmmunity in Washingtn after cmpleting yur higher educatin. Attach all academic transcripts frm the last five-year perid. Official r cpies f fficial transcripts are acceptable. If it has been mre than five years since yu last attended cllege, attach a cpy f yur cumulative transcript frm the cllege mst recently attended. If yu have less than tw years f cllege, als attach a cpy f yur high schl transcript (r yur GED test scres results, if applicable). Attach letters f recmmendatin frm individuals wh are nt members f yur immediate family: Applicants fr initial (first-time) awards: A minimum f three recmmendatin letters required. One letter must address yur persnal cmmitment t serve the American Indian cmmunity in Washingtn. At least tw letters must verify yur scial and cultural ties t an in-state American Indian cmmunity. Renewal applicants: A minimum f ne current letter f recmmendatin. The letter must describe yur persnal cmmitment t serve the American Indian cmmunity in Washingtn as well as yur clse scial and cultural ties t the Native cmmunity in the state. i
Hw d I apply fr the schlarship? cntinued: Sign and mail a hard cpy f the applicatin, with all required attachments, t the American Indian Endwed Schlarship (AIES) prgram at the Washingtn Student Achievement Cuncil. Apply fr state and federal need-based financial aid at the cllege r university yu will attend next academic year, using the FAFSA (Free Applicatin fr Federal Student Aid). Financial need is amng the criteria fr selectin as a schlarship recipient. The FAFSA is available at yur schl s student aid ffice r n-line at www.fafsa.ed.gv. Hw are recipients selected? These schlarships are awarded n a cmpetitive basis. A selectin cmmittee cmprised f representatives frm the American Indian and higher educatin cmmunities in state will review applicatins and select recipients. Selectin criteria emphasize the applicant s scial and cultural ties, and cmmitment t return service, t the American Indian cmmunity within the state, as dcumented by the tw persnal statements and supprted by the letter(s) f recmmendatin. Additinal criteria include academic merit, and a pririty fr upper divisin and graduate students. Hw much will I receive if I am selected? The prgram advisry cmmittee decides the ttal number and value f schlarships t be awarded each year after a discussin f current schlarship issues and an analysis f endwment interest earnings received during the prir year. Histrically, the schlarships have been awards f $500 - $2,000 each fr ne academic year. Awards will nt exceed the recipient s financial need as calculated by the cllege student aid ffice. In sme cases, the schlarship may be adjusted t prevent cnflict with the receipt f ther student financial aid grants. The recipient must be enrlled by fall term as a full-time student at an eligible, participating cllege r university in Washingtn and be financially needy, as determined by the cllege financial aid ffice, at the time f schlarship disbursement. Funds are disbursed each academic term thrugh the recipient s cllege. Individual recipients may receive up t a cumulative maximum f five academic years f schlarship assistance thrugh the prgram and must submit a renewal applicatin fr award cnsideratin each year. Any renewal is fr ne academic year, decided n a cmpetitive basis, and at the discretin f the cmmittee after a thrugh review f an applicant s renewal applicatin, academic merit, and cntinued cmmitment t return service t the American Indian cmmunity in state. Pstmark yur applicatin n later than February 1. Late r incmplete applicatins are nt cnsidered. Mail the entire applicatin as a single unit (including all required attachments) t: American Indian Prgram Washingtn Student Achievement Cuncil 917 Lakeridge Way, Olympia, WA 98502 (use the street address fr UPS r FedEx delivery) P O Bx 43430, Olympia, WA 98504-3430 (use the PO Bx fr US Pstal Service delivery) Questins? cntact: Ann M. Vyles, Prgram Assciate Direct: 360.753.7843 Fax: 360.704.6243 (direct) r 360.753.7808 (main agency) (A printed hard cpy riginal by regular pst must fllw faxed applicatins) E-mail: aies@wsac.wa.gv ii
Eligible In-State Institutins fr the American Indian 2015-2016 Academic Year Public fur-year research institutins: University f Washingtn Washingtn State University Public fur-year cmprehensive institutins: Central Washingtn University Eastern Washingtn University The Evergreen State Cllege Western Washingtn University Independent fur-year institutins: Bastyr University City University f Seattle Crnish Cllege f the Arts Gnzaga University Heritage University Nrthwest University Pacific Lutheran University St. Martins University Seattle Pacific University Seattle University University f Puget Sund Walla Walla University Western Gvernr s University-Washingtn Whitman University Whitwrth University Public tw-year technical clleges: Bates Technical Cllege Bellingham Technical Cllege Clver Park Technical Cllege Lake Washingtn Technical Cllege Rentn Technical Cllege Seattle Vcatinal Institute Public tw-year cmmunity clleges: Bellevue Cllege Big Bend Cmmunity Cllege Cascadia Cmmunity Cllege Centralia Cllege Clark Cllege Clumbia Basin Cllege Edmnds Cmmunity Cllege Everett Cmmunity Cllege Grays Harbr Cllege Green River Cmmunity Cllege Highline Cmmunity Cllege Lwer Clumbia Cllege Nrth Seattle Cmmunity Cllege Olympic Cllege Peninsula Cllege Pierce Cllege Seattle Central Cmmunity Cllege Shreline Cmmunity Cllege Skagit Valley Cllege Suth Puget Sund Cmmunity Cllege Suth Seattle Cmmunity Cllege Spkane Cmmunity Cllege Spkane Falls Cmmunity Cllege Tacma Cmmunity Cllege Walla Walla Cmmunity Cllege Wenatchee Valley Cllege Whatcm Cmmunity Cllege Yakima Valley Cmmunity Cllege Tribal clleges: Nrthwest Indian Cllege iii
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Applicatins are due t the Cuncil pstmarked by February 1. Sectin I: Applicant Infrmatin (Select ne) I am applying fr an initial schlarship: I am applying fr a renewal schlarship: I am applying fr a schlarship fr academic year beginning fall term (academic year) 1. Last name First name M.I. 2. Scial Security number (required) 3. Current address: Street City State Zip 4. Phne 5. Permanent address (if different): Street City State Zip 6. Alternate Phne 7. Email address 8. I have been a Washingtn state resident (fr tuitin purpses *) since: Year Mnth If a nn-resident, check here: (* see Chapter 250-18 WAC) 9. Tribal affiliatin: Enrlled? Membership/enrllment # (if applicable): Yes N Sectin II: Educatinal backgrund 10. Date f high schl graduatin (r GED received): Mnth Year 11. Educatin infrmatin. List schls in rder f attendance (mst recently attended first ; attach cpies f grade transcripts): Name f high schl/cllege/university City & State Dates f attendance Degree, if any Cum. GPA Sectin III: Extracurricular activities 12. List majr schl, cmmunity, and leadership activities. (Attach a separate sheet if necessary.) 1
Sectin IV-a: Current Educatinal Plan (All applicants) 13. Cllege yu will attend next fall: 14. Class level next fall (i.e., freshman, sphmre, junir, senir, r graduate): 15. Intended field f study: 16. Date f expected prgram cmpletin: Mnth Sectin IV-b: Changes t prir Educatinal Plan (Renewal applicants nly) 17. Did yur curse f study change within the past year? N Yes (if yes, describe the reasn belw): Year Sectin V: Certificatin by Institutinal Academic Dean, Department Head, r Advisr (Renewal applicants nly) 1. T the best f my knwledge, is pursuing a prgram f study that leads t a(n) (Name f Student) degree/certificate in. (type: AA, BA, BS, MA, MS, Ph.D., etc.) 2. This student is n-track t cmplete his r her degree r certificate by: Mnth 3. Academic prgress achieved by this student in his/her majr area f study: (field, prgram, r prfessin) EXCEEDS expectatins MEETS expectatins DOES NOT MEET expectatins 4. Prvide ther cmments that wuld help the cmmittee distinguish this student academically frm ther applicants: Year Dean, Department Head, r Advisr Signature Name, Title, and Department (please type r print) Name f Institutin Institutin Address E-mail address Phne ( ) Date Sectin VI: Required Attachments (All applicants) NOTE: Give careful thught t hw yu develp these required attachments. These dcuments are the fundatin upn which schlarship recipients will be chsen. An missin f, r deficiency in, any cmpnent may render the applicatin incmplete, disqualifying it fr schlarship cnsideratin. 1. Statement f Clse Scial & Cultural Ties: Attach a separate sheet f paper and describe in detail yur clse scial and cultural ties t an American Indian cmmunity in Washingtn. If yur riginal ties are t an ut-f-state tribe, als describe hw yu have established clse scial and cultural ties t the American Indian cmmunity in Washingtn. 2
Sectin VI: Required Attachments, cntinued: (All applicants) 2. Statement f Cmmitment t Return Service: Attach a separate sheet f paper and describe hw yu plan t serve an instate American Indian cmmunity upn cmpleting yur educatin, and hw yur cntributin is intended t affect the cmmunity. 3. Letter(s) f Recmmendatin: (Letters must be frm individuals wh are nt immediate family members) Applicants fr initial (first time) awards: Attach a minimum f three recmmendatin letters. One letter must address yur persnal cmmitment t serve the American Indian cmmunity in Washingtn. At least tw letters must discuss yur clse scial and cultural ties t an American Indian tribe r cmmunity in Washingtn. Yu are encuraged t include a furth recmmendatin letter, frm a recent teacher r instructr, which addresses yur current academic perfrmance. Renewal applicants: Attach at least ne current letter f recmmendatin. The letter must speak t yur persnal cmmitment t serve, as well as yur clse scial and cultural ties t, the American Indian cmmunity in state. 4. Transcript(s): Official r cpies f fficial transcripts are acceptable. Attach cumulative cllege transcripts frm the last five-year perid, t include fall term f the current applicatin year. If yu have nt attended cllege in mre than five years, attach a cumulative transcript frm the mst recent cllege attended. If yu have less than tw years f cllege, als attach yur high schl transcript (r GED scres) with the cllege transcript(s). Reminder: If yu have nt already dne s, als apply fr ther state and federal student financial aid. Cntact the cllege yu plan t attend fr the apprpriate student financial aid applicatin, r cmplete the n-line frm lcated at www.fafsa.ed.gv. Sectin VII: Release f Infrmatin Statement (Required f all applicants) American Indian Prgram Financial need is ne criterin used t determine yur eligibility fr the schlarship. This signed frm will allw the schl(s)/cllege(s) t prvide financial aid, enrllment, and transcript infrmatin t the Washingtn Student Achievement Cuncil. The infrmatin will be used t determine eligibility fr the schlarship. Applicant name (include all names by which schls identify yu, if mre than ne) (please print) Applicant Scial Security Number I authrize, and/r ther schl(s) (Name f schl yu will attend as f fall term) named in this applicatin, t release all necessary infrmatin abut my schling t assist the Washingtn Student Achievement Cuncil in its administratin f the American Indian prgram. This includes all demgraphic, enrllment, academic transcript, and student aid infrmatin. Applicant signature Date Sectin VIII: Applicant Certificatin and Media Release (Required f all applicants) By my signature, I affirm that the infrmatin cntained in this applicatin is true and crrect t the best f my knwledge. If I am selected t receive the schlarship, I understand that I must be enrlled full -time by fall term f the award year at an eligible cllege r university in Washingtn state. I understand that the Washingtn Student Achievement Cuncil may release certain infrmatin cntained in this applicatin t interested parties, such as the news media and legislative persnnel, fr the purpse f recgnizing the accmplishments f schlarship recipients. I have checked the shaded bx belw nly if I DO NOT wish this infrmatin t be released. * * I d NOT authrize the Cuncil t release my infrmatin fr the purpse f recgnitin. Applicant signature Date 3