ࡱ > a bjbj͚ 7R I\I\ c 6 6 8 +m l l l l l l l $ Eo q l S | l l % % % R l % l % % . b Rj FL ! e @ l l 0 +m "f 0 r v r Rj Rj r >k X % l l % +m r 6 > t : WOOD MOUNTAIN LAKOTA FIRST NATION POST SECONDARY MANUAL POLICY & PROCEDURES Table of Contents Vision Statement .4 Preface.5 Section 1: Post Secondary Policies Policy Objectives6 Roles and Responsibilities ....7 Post Secondary Eligibility .10 Post Secondary Student Support Program .. 11 Student Eligibility Criteria . 12 Order of Priority for Funding Allocations .. 14 Post Secondary Application Criteria .. 16 Additional Student Support Program . 18 Limits of Support . 19 Disqualification for Further Funding ..20 Refundable Benefits ... 21 Confidentiality 22 Section 2: Applications and Procedures First- Time Student Application Process .......................... 23 Continuing Student Application Process 24 Evaluation of Applications and Procedures After Approval 25 Conflict Resolution Procedure: Student Ombudsman Services 26 Section #3 Glossary of Terms Glossary of Terms. 27 Appendix A Incentives and Scholarships . 32 Appendix B Living Allowance Rates 33 Appendix C Application form for Post Secondary Educational Assistance 35 VISION STATEMENT The Wood Mountain Lakota Nation will support the self-determination and self-sufficiency of our band membership through educational oppurtunities, which support the enhancement of our communitys social, economic, political, and cultural realities. We recognize that providing educational oppurtunities is a means of ensuring the well being of our future generations. PREFACE In response to the current funding allocations by the Department of Indian and Northern Affairs Canada, the development of a new post secondary policy was initiated. The policy is based on recommendations made by former students and changes in the labour market trends where there is a higher demand for persons in the trades and technology. This is also true for employment oppurtunities within our local economy, which is based on trade and farming related fields. This has resulted in changes to our funding criteria. The Wood Mountain First Nation receives Post Secondary funding annually through the Department of Indian and Northern Affairs Canada. The funds for our Band are used for the purpose of training members to move towards both individual and community self-sufficiency. We believe that advancement of our community members support not only the health and well-being of our community but also provides individuals with the skills needed to survive in the contemporary world. The main objectives of the funding dollars granted to our community are to improve the socio-economic conditions for Wood Mountain First Nations members residing both on and off Reserve. Moreover, the allocated funding also serves to encourage greater representation of our band members in the Canadian labour market. Students applying for funding must meet the criteria as stated in the policy guidelines. Our purpose is to ensure that all eligible Band Members will receive potential funding based on inclusive and equitable requirements. Section 1: Post Secondary Policies Policy Objectives The Wood Mountain Lakota Nation aims to assist Band Members by: Providing oppurtunities for academic, financial, spiritual, and social supports facilitating an easier transition into post secondary training and in turn enhancing student retention. Offering career guidance and programming which reflects the social, economic, and political realities of our community members while preparing them to contribute to economic sustainability Iniatives both within and outside of our community. Exploring initiatives in consultation with all stakeholders including community leaders, federal partners, educational service providers, and community members. The consultative and collaborative process supports shared objectives with potential funders while remaining consistent with our community vision. To link a portion of our training programs to community sustainability projects to support future employment within our community. Provide funding allocations for students wishing to attend concurrent, College, and University preparation programs to allow for necessary upgrading and remedial training improving their ability to successfully complete programs. To regularly communicate with students for the purposes of providing support and obtaining statistical information to ensure that our policy continues to meet student needs. Roles and Responsibilities The Chief and Council are responsible for: Administering funding dollars to students registered in post secondary programs. Ensuring equitable access of funding dollars for all members of the Wood Mountain Lakota Nation. Ratifying the annual Post Secondary Budget. Informing the Post Secondary Counsellor about potential changes to the post secondary policy, budget and funding criteria. Making final decisions about the recipients of post secondary funding. Employing a Post Secondary Counsellor to perform the day- to day administration of the Post Secondary Student Support Program. The Post Secondary Counsellor is responsible for: Ensuring that the policy implementation and changes remain consistent with funding guidelines and the educational mandate outlined by Wood Mountain Lakota Nation. Assisting students in accessing post secondary funding programs outside of funding allocations from the band in the event where they are not eligible for band funding. Providing assistance to students to access information pertaining to potential scholarships, bursaries, and alternative sources of funding in addition to regular student funding allocations. Supporting the emotional, intellectual, and physical well-being of each student to enhance student retention rates. Researching training and educational programming which support community development and self-sufficiency of band membership. Meeting with the students a minimum of once during the academic year to monitor progress and assess the students academic, personal, financial, and social needs supporting higher student retention. To act as a student ombudsman in the event that a student does not agree with a funding decision. Regularly review the Post Secondary Policy for the purposes of developing and recommending amendments to the existing policy as required. Overseeing the administration of the Post Secondary and funding providing consultation, support, and direction to the Chief and Council. Reporting to the Chief and Council about the status of the Post Secondary Program no less than once per year. The student is responsible for: Finding support and services at their institution of choice to maximize their potential to complete programs. Informing the Post Secondary Counsellor of tuition costs at least two weeks prior to the program start date. Providing a current mailing address, phone number, emergency contact, setting up account with a banking institution used by the Band, and providing bank account information for direct deposit of cheques. Maintaining a full course load as outlined in the Post Secondary Policys program criteria guidelines. Advising the Post Secondary Counsellor about program changes, such as changes in the area of study, as soon as the information becomes available. Informing the Post Secondary Counsellor as soon as they withdraw from a program. Previously funded students are required to submit a transcript of marks for the years they received assistance through the PSSSP program. Achieving a minimum grade point average of 2.0. In cases where a student encountering academic difficulties, they are responsible to contact the Post Secondary Counsellor who will assist them in researching potential academic supports. Notifying the Post Secondary Counsellor in writing prior to the end of the academic year about their plans to continue on in their field of study. Providing copies of their registration documents and acceptance letter at least two weeks prior to their program of study. Submitting an official transcript or an official progress report at the end of each academic semester. Submitting in writing an educational and goals essay prior to the beginning their program of study. This must include information about the applicants career aspirations, educational goals, and potential supports the student feel they require enhancing their ability to be successful. Post Secondary Eligibility The Wood Mountain Lakota Nation has an ongoing funding agreement with the Department of Indian and Northern Affairs Canada. In order to ensure a continued positive relationship with the Federal Government, we are required to maintain management systems and accountability measures to secure the continuation of Post Secondary Funding. When surplus funding from INAC or alternative funding is available, the Band will contribute dollars to Band applicants for the purpose of training and education. Such surplus or alternative funding will be subject to the same policy objectives as those required by our Federal Funders. Consequently, the criteria for eligibility has been implemented for both Post Secondary Institutions and Band Members to remain consistent to the funding restraints as outlined by the Department of Indian and Northern Affairs Canada. Post Secondary Student Support Program The Wood Mountain Lakota Nation will sponsor Post Secondary students in the following program categories. These will be defined according to funding guidelines outlined by the Department of Indian and Northern Affairs referred to as Post Secondary Student Support Programs (PSSSP) which is divided into four areas of training. These will include: Level 1: The University College Entrance Preparation (UCEP) designed to offer educational support to students requiring upgrading services to improve their academic skills prior to entering degree or diploma programs. Such support is available for students attending Canadian Post Secondary Institutions. Level 2: Community College and CEGEP diploma or certificate programs Level 3: Undergraduate university programs Level 4: Advanced professional degree programs e.g. Dentistry, Medicine, Masters or Doctoral Programs Student Eligibility Criteria Eligible students must be a Band Member of the Wood Mountain Lakota Nation. Students are required to be accepted into degree, certificate, or university and college preparation (UCEP) granting institutions recognized by Provincial Governments prior to Post Secondary Support funding dollars. Students must maintain a grade point average of 2.0 or an average which allows them to continue in their program of study in order to remain eligible for post secondary funding. First time applicants must complete a current application form containing an educational and goal essay, a program plan which outlines the number of years required to complete their training, a transcript of their most recent marks from either a secondary or post secondary program, copies of the institutions completed registration form, and a copy of a letter of acceptance. All applications must be complete and must be submitted to the Post Secondary Counsellor no later than two weeks prior to the program start date. Each application will be reviewed and will be accepted in whole or in part or rejected in whole or in part. Students will only be provided with ongoing program funding if they have are registered for the same program in the previous year or have completed their program of studies and are continuing on in a different program. Students entering into a new program must reapply for funding. Students are required to attend a minimum of 24 credit hours per academic year, four courses, or the equivalent amount of courses recognized by the institution. Students will not be eligible for funding if the program duration is less then eight months through the Post Secondary Student Support Program will be required to apply for financial assistance through AHARDA funding or surplus educational funding when available. Students must complete an interview with the Post Secondary Counsellor prior to the beginning of the academic year to assess the need for potential services and supports. Students must be registered in a provincially or nationally recognized institution which has the ability to grant degrees, diplomas and certificates in order receive Post Secondary Student Support. (Programs which do not fall within these guidelines will be sponsored by other funding programs when available.) Order of Priority for Funding Allocations The Wood Mountain Lakota Nation will prioritize allocations of student support funding using the following guidelines for applicants: Students currently enrolled in a program of study who are returning to a full time degree and diploma program, or students who have completed a college entrance preparation program and are continuing on in a post secondary program. Students who have graduated from a Senior Four, grade 12, or CEGEO program and have been accepted into a post secondary institution in a certificate, diploma, or degree program and have not received funding in previous years. Students who have completed a mature high school diploma and have not received funding allocations for post secondary attendance in previous years. Students who have completed an undergraduate program who are continuing on to an advanced degree program without a break in their funding. Students who are reapplying for funding who were deferred in previous years due to the lack of funding available. Students applying for Continuing Education Courses or Correspondence courses at a local University or College. Students attending Continuing Education Courses will be eligible for tuition and books only, unless they are attending at least 12 credit hours per semester or 24 credit hours annually. Students who require upgrading services at a public post secondary institution. Students who are pursuing training in another field of study. Students who have previously received funding but failed to complete their post secondary programs. Re-admitted Required to Discontinue students. Post Secondary Application Criteria All Band Members are entitled to apply for Post Secondary Student support. Acceptance for student support will be dependent on the applicant meeting eligibility criteria or on the availability of funding. In cases where the applicant has been approved for funding for the next academic year and decides not to attend they must submit a letter to the Post Secondary Counsellor indicating their plans not to continue. However, the applicant must still submit an official transcript of marks at the completion of the academic year. An applicant may not apply for new or ongoing funding unless they submit all required information including a transcript of marks, acceptance letter, applications forms, etc. If the applicant fails to submit the required information the Post Secondary Counsellor at their discretion my make a request for the required documents from the student. If the student still fails to provide the required documentation the Chief and Council may request full reimbursement by the student for all tuition cost and living allowance for the semester in which they were last approved and shall be considered a debt owed to the Wood Mountain Lakota Nation. In order to be eligible for consideration for post secondary funding the applicant must submit complete applications into the Post Secondary Counsellor: On or before June 30 where the funding is sought in respect of an academic semester or year commencing prior to August 15 or later in that calendar year. On or before March 31 where the funding sought is in respect of an academic semester or year commencing between May 1 and August 14 inclusive in that same academic year; On or before October 31 where the funding sought is in respect of an academic semester or year commencing between January 1 and April 30 inclusive in the next following Calendar year. The deadlines for filing completed applications may be extended at the discretion of the Post Secondary Counsellor dependent on the availability of funding and special circumstances. Additional Student Support Program Students will be eligible to apply for additional support which will be dependent upon the availability of funding. Applicants for Post Secondary Student Support Funding are eligible to apply for the follow categories of student support: Student fees for compulsory or optional tutorials directly related to the program of study. Examination fees related to program acceptance, course completion or program completion. Practicum allowances for cooperative education programs in the event of that it is not that is not covered by alternative sources of funding or if a salary is provided directly by the employer. Expenses for eye glasses paid directly to the business minus the allocations provided by the Department of Indian and Northern Affairs Canada. Physical, mental, or learning disabilities which give rise to special needs funding where they do not otherwise qualify for special funding provisions. Request are to be made to the Post Secondary Counsellor and will be decided on by the Quorum of Council of the Wood Mountain Lakota Nation. Limits of Support All financial support is limited upon the availability of funding provided by Indian and Northern Affairs Canada and internal Post-Secondary budgets allotted by the Wood Mountain Lakota Nation towards post-secondary expense categories. Funding for required books shall not exceed $400.00 per semester and $800.00 per academic year, unless the program of study requires books and supplies exceeding the regularly allotted amounts. In such cases the student must provide documentation from the institution in writing special program expenses. Compulsory or optional tutorials shall not exceed $200.00 dollars per semester. All payments will be made directly to the tutor. Student allowance will be based on the number of dependents of the applicant. Part time students, students enrolled in correspondence courses, or distance education students will be provided with tuition and books only. Living allowances will not be allocated for students within this category. Applicants wanting to attend programs outside of Canada while a program is available in Canada will not receive tuition exceeding the rates that available at Canadian institutions to acquire the same training. In cases where the training is not available in Canada, student living allowances and tuition will be paid in Canadian funds. Disqualification for Further Funding Students are required to repay any outstanding debts for the pervious or present educational funding provided by the band before being considered for future funding allocations. An applicant who fails to receive a passing grade in more than 50% of their courses which has been funded through Post-Secondary Student Support Funding will not be eligible to re-apply for funding for a period of a year. In such cases, a student who is granted funding after the period of probation must maintain a passing grade in all registered courses in order to continue. Students who continue to receive funding allocations after leaving a program will be responsible to reimburse the Band for the their living allowance prior to being eligible for future funding. Students who withdraw from a program after the institutions tuition reimbursement deadline must provide medical documentation or certificate from a mental health professional. If such documentation is not received the student will be placed on academic probation and will not be eligible for funding for one academic year. Refundable Benefits Any factual misrepresentations on a funding application which results in the applicant receiving an excess of funding in relations to the benefits outlined in the policy manual will be required to refund the band for the additional expenses and will not be entitled to further funding until such matters are dealt with. Applicants who have a change in domestic circumstances after submission of the application form must inform the Post-Secondary Counsellor in writing as soon as the change occurs. Over payments resulting from a change in living circumstances will be result in the applicant refunding any amount exceeding the entitled allotment. Any approval which is granted prior to the applicant submitting an official transcript of marks shall be deemed conditional upon the receipt of the required information. If upon receiving the marks the Chief and Council feel that the conditional status should not have been granted, the applicant will be responsible to make repayment arrangements with the Band for reimbursement. The Chief and Council may partake in legal proceedings to collect any outstanding debts in cases where the applicant fails to repay the amount owing to the Band. Confidentiality The Post-Secondary Counsellor shall maintain an open file on each applicant for one year regardless of the outcome of the funding decision. Any information on an applicants file is considered confidential. Access to materials shall be restricted to the Post Secondary Counsellor. At no time shall the Post Secondary Counsellor release personal information to outside parties unless a written release is provided by the applicant specifying who is allowed to view the file. This follows the restrictions outlined in the Freedom of Information Privacy Act. The applicant is entitled to a request a copy of their file. A written request must be provided to the Post Secondary Counsellor by the student who is entitled to receive the file information no more then thirty days after the receipt of the letter. Section 2: Applications and Procedures First Time Student Application Process: All first time students applying for funding from the Wood Mountain Lakota Nation must have: A completed application form. A signed statutory declaration to assist with determining applicable living allowances; any applications claiming dependants must submit official documentation from Revenue Canada stating the applicant is receiving Child Tax Benefits for the claimed dependent(s). A photocopy of the most recent status card. A letter of acceptance from their post-secondary institution. An official transcript of marks from previous academic institutions or secondary school. A letter of intent which describes your educational goals including your plans for the current academic year, level of education, program of studies, connections your program of studies has to the labour market, and how long it will take to complete your program of studies. A single student funding contract which must be submitted to the Post Secondary Counsellor. A Student authorization waiver permitting the Post Secondary Counsellor access the students records at a participating institution of studies. This will allow the Post Secondary Counsellor to verify class attendance by participating students. Continuing Student Application Process: All continuing students applying for funding from the Wood Mountain Lakota Nation must have: A completed application form. A signed statutory declaration to assist with determining applicable living allowances. A copy of an official transcript of marks last received in the program of study. A Student authorization waiver permitting the Post Secondary counsellor access to your student records at your participating institution of studies. This will allow the Post Secondary Counsellor to verify class attendance by participating students. A signed funding contract which must be received by the Post Secondary Counsellor. Evaluation of Applications and Procedures After Approval The Wood Mountain Lakota Nation Chief and Council in consultation with the Post Secondary Counsellor will review all funding applications annually. Decision will be based on policies as stated in the Post-Secondary Policy Manual. After each deadline date the Chief and Council and Post-Secondary Counsellor will: Review all funding applications. Set up an interview with eligible applicants where necessary. Prepare Letters of Acceptance for all successful applicants to be sent to both the student and the participating institution no later than three weeks after the approval date. Provide the sponsored student with a schedule for payment of monthly allowances. Make tuition payment arrangements participating institution. Prepare a book and supply check to be direct deposited into the students bank account no later than one week prior to the beginning of the academic year. Conflict Resolution Procedure: Student Ombudsman Services The role of the Student Ombudsman is to act as a liaison between the student and Chief and Council. In this role it is the duty of the Post-Secondary Counsellor to speak on behalf or in support of the applicant in addressing their concerns. The Student Ombudsman will be utilized in the following manner: Within 30 days of a decision being made, the applicant can file their concerns with the Post-Secondary Counsellor who will act as an Ombudsman for the student. Until the decision has been overturned it shall be deemed valid. Pending a final decision being made in regards to such matters as repayment recovery for costs or final application denials will not be made. A letter will be sent to the applicant immediately following the decision no more than 30 days after the concern was filed. No party involved in the matter shall obtain legal representation prior to the 30 days after a final decision has been made. Any information provided to the Post Secondary Counsellor, in their role as Ombudsman, shall remain confidential unless they receive written permission from the applicant to share information with other involved parties. Section 3: Glossary of Terms Academic Plan: An outline of the program completion requirements and prerequisites completed by the students at the beginning of each semester. Academic plans must coincide with the program requirements. Academic Probation: A period of one academic year where a student is unable to re-apply for funding, usually instituted for failing to meet expectations outlined in the post-secondary policy. Academic Year: The academic year, in general, refers to two semesters approximately eight months in duration or as otherwise defined by the post-secondary institution. Applied Degree: A credential, which can be completed in approximately a three or four year time frame that requires a student to complete both college and university training. Band Member: A person who is a registered as a member according to the Wood Mountain Lakota Nation band membership policy guidelines. Canadian Public Institution: An institution who receives funding support from the Provincial and Federal Governments in Canada. Certificate: An academic credential which an individual can complete in one academic year or less. Contingency Funding: Funding allocated to students for emergencies such as personal or family illness, accident, or bereavement. Dependent spouse: An individual who has resided with a PSSSP student in a common law relationship for over a period of six months or whose marriage is recognized by the a Province within Canada whose income does not exceed $6500.00 per annum. Dependent: Any family member who resides with the PSSSP recipient full-time requiring economic support who are either seventeen years of age or younger, between the ages of fifteen and twenty-one who is enrolled in an educational institution full-time, or are considered dependent children on the Child Tax Assessment Form. Degree: A credential which can be completed in a three or four year time granted by a university or university college. Diploma: A credential which can be completed a college or university in two years or more. Full-Time Student: A student who is registered for four courses or the equivalent of twenty-four credit hours during each semester throughout their program of study. In the event that the program requirements exceed the course and credit hour requirements outline in the post-secondary policy, students will be required to attend to the course expectation at their hosting institution. Full-Time Spring and Summer Student: Students who have a course load of two courses (or) two three credit hour courses (or) one six hour credit course (or) the equivalent as deemed by the post-secondary institution, during each spring and summer session. Full Program Load: The recommended course load outlined by the hosting post-secondary institution that a student must complete to finish their program with a minimum time frame. Harassment: The policy outlined by the hosting institution aimed to ensure the safety of the students and staff of the hosting institution. Medical Releases: Medical certification obtained by a medical or mental health professional which supports reason for a student being absent from their academic classes or program. Medical or mental health certificates must be provided to the Post Secondary Counsellor ten days after the onset of the personal or medical condition. Medical releases are required for absences exceeding five days or more (or) in cases where a student demonstrates continual difficulties with regular program attendance. Normal Program Length: The minimum number of courses a student is required to take to complete the program within a number of years outlined by the institution. Part-Time Student: A student whose program attendance falls under the guidelines outlined for full-time student status (Refer to definition of Full Time Student in the glossary of terms). Post-Secondary Education: Programs offered within a recognized institution which allow individuals to complete the credential requirement or a certificate, diploma and (or) degree. Post-Secondary Institution: A certificate, Diploma or degree granting institution which is accredited by a province, territory or country. Such institutions often have credentialing arrangements affiliated with other post-secondary institutions where students may be eligible to transfer credits into other areas of study. Private Post Secondary Institution: A post-secondary institution which receives the majority of its funding through sources outside of the Federal and Provincial Government. Semester: The time designated by the hosting institution, which generally divides the academic year. Sponsorship: Funding support for individuals attending post-secondary facilities which may include a provision of tuition costs, books, supplies, living allowance and travel allowance. Spouse: An individual who has resided with a sponsor student for over a period of 6 months prior to application for funding assistance or who is legally residing with the sponsor student according to the Family Law defined by a Province. Waiting List: A list of person who are waiting for academic funding. Students on the wait list will be selected according to funding categories outlined in the post-secondary guideline framework. Students on the waiting list are expected to reapply each academic year if they desire to remain on the waiting list. Appendix A Incentive and Scholarships The Wood Mountain Lakota Nation takes pride in the academic achievement of our students. We believe that such achievements should be honored by our Community. Pending the availability of financial resources the Wood Mountain Lakota Nation will set up the scholarship fund for students who have achieved academic excellence in their field of study. Scholarships will be given to: Students graduating from a Secondary Institution who have achieved an 80% average or higher and are planning to enter a Post Secondary Institution for the next academic year will be entitled to a $200.00 dollar scholarship. Students receiving a GPA of 3.5 or higher at the end of a semester of studies will be entitled to an academic scholarship of $250.00 dollars. Students achieving a 4.0 GPA at the end of a semester of studies will be provided with an academic scholarship of $500.00. Students graduating from programs will a 250.00 check upon submission of their final transcript. Appendix B Living Allowance Rates Allocations for living allowances should be calculated using the following structure: Single student Married student with employed spouse Married student with dependent spouse Single student with dependent children STUDENT ALLOWANCE RATES ClassificationMonthly AllowanceMonthly Allowance Supplement In High Rent AreasSingle Student8250Married student with employed spouse6750 With 1 dependent8500 With 2 dependents10250 With 3 dependents12000 $50 per month will be provided for each additional dependentMarried student with dependent spouse8250with 1 additional dependents10000With 2 additional dependents11750With 3 additional dependents13500$50 per month will be provided for each additional dependentSingle parentWith 1 dependent10500With 2 dependents1225100With 3 dependents1400150$100 per month will be provided for each additional dependent APPLICATION FORM FOR POST SECONDARY EDUCATIONAL ASSISTANCE Wood Mountain Lakota Nation Post Secondary Program P.O. Box 1792 Assiniboia, Saskatchewan S0H 0B0 Post Secondary (306) 266-2039 Education Admin (204) 261-3246 Fax Number: (306) 266-2024 Let us put our minds together and see what life can make for our children. Chief Sitting Bull POST SECONDARY STUDENT REQUEST FOR FUNDING-CONTINUING APPLICATION REGISTRATION FORM ******************************************************************** Privacy Act Statement The information you provide on this document is for the purpose of administering post-secondary student financial assistance. Personal information that you provide is protected under the provision of the Privacy Act. **PLEASE PRINT NEATLY AND COMPLETE ALL REQUIRED INFORMATION** DATE OF APPLICATION: _________________ ACADEMIC TERM: __________________________ FULL TIME: ________________________________ PART TIME ________________________ PERSONAL INFORMATION NAME: ______________________________________________________________ (Surname) (First) (Middle) MAIDEN NAME (IF APPLICABLE) ___________________________________________ E-Mail: _______________________________________________________________ TELEPHONE: ___________________________________________________________ TREATY NUMBER: __________________________ Date of Birth ____/_____/_________ D M Y SOCIAL INSURANCE NUMBER: _______________________________________________ CURRENT ADDRESS: _______________________________________________________ TOWN/CITY: ____________________________________________________________ POSTAL/ZIP CODE: _______________________________________________________ COUNTRY: _____________________________________________________________ DEPENDANTS: NAME D.O.B. (M/D/Y) SCHOOL ATTEND TOWN/CITY ____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________ IN CASE OF EMERGENCY NEXT OF KIN: ________________________________________________________ ADDRESS: _________________________________________________________ TOWN/CITY: _______________________________________________________ PROV/STATE: ______________________________________________________ COUNTRY: ________________________________________________________ PHONE NUMBER: __________________________________________________ ISTITUTE YOUR ARE PLANNNING TO ATTEND: ______________________________ STUDENT NUMBER: ________________________________________________ NAME OF PROGRAM: ______________________________________________ CREDITS TOTAL: ______________________________________ COURSES PLEASE CHECK OFF YOUR STANDING (Year of Study you are entering) AT THE TIME OF APPLICATION ON THIS FORM. YEAR: 1_____ 2_____ 3_____ GRADUATE LEVEL _____________ THE FUNDING PERIOD START DATE: ________________ END DATE _____________ DOCUMENTATION REQUIRED: FINAL REGISTRATION FOR NEXT FUNDING TERM, IF ALREADY ON FILE JUST CALL CONFIRM THAT NO CHANGES HAVE BEEN MADE SINCE IT WAS SENT IN TO THE OFFICE. MARK TRANSCRIPTS WHEN THE TERM IN PROGRESS HAS BEEN COMPLETED PLEASE SEND TO OUR OFFICE AT: WOOD MOUNTAIN LAKOTA NATION P.O. BOX 1792 ASSINIBOIA, SASK. SOH 4L0 FAX: (306) 266-2024 wmlakota@sasktel.net STUDENTS NEED TO ALLOW SUFFICIENT TIME FOR CANADA POST TO DELIVER YOUR APPLICATION BEFORE THE DEADLINE DATE, PLEASE CALL TO CONFIRM THAT APPLICATION HAS BEEN RECEIVED WHETHER FAXED OR MAILED TOLL FREE # IS 306-266-2039 IF APPLICATION IS NOT RECEIVED BEFORE THE DEADLINE DATE, IT IS ASSUMED THAT FUNDING IS NO LONGER REQUIRED, AND STUDENTS NAME WILL BE DELETED FROM FUNDING LIST FOR THE NEXT TERM. ** STUDENTS MUST RE-APPLY BEFORE THE DEADLINE DATE AFTER EACH TERM FOR CONTINUED FUNDING** STUDENT RELEASE INFORMATION: STUDENTS APPROVAL: FILES I HEREBY AUTHORIZE THAT ALL PERTINENT ACADEMIC AND PERFORMANCE INFORMATION BE RELEASED TO WOOD MOUNTAIN LAKOTA NATIONS POST SECONDARY COUNSELLOR UPON REQUEST: STUDENTS NAME: (PLEASE PRINT) ___________________________________ STUDENTS SIGNATURE: ____________________________________________ INSTITUTE: _______________________________________ TERM __________ DATE: ___________________________ STUDENT # ________________________ ____________________________________________________________________ STUDENTS APPROVAL TO BE SENT TO INSTITUTE I HEREBY AUTHORIZE THAT ALL PERTINENT ACADEMIC AND PERFORMANCE INFORMATION BE RELEASED TO WOOD MOUNTAIAN LAKOTA NATIONS POST SECONDARY PROGRAM UPON REQUEST. STUDENTS NAME: (PLEASE PRINT) _______________________________________ STUDENTS SIGNATURE _________________________________________________ INSTITUTE: ________________________________ TERM: ____________________ DATE: _________________________ STUDENT # ____________________________ Wood Mountain Lakota Nation Post Secondary Program P.O. Box 1792, Assiniboia, Saskatchewan S0H 4L0 Phone: (306) 266-2039 Fax: (306) 266-2024 WOOD MOUNTAIN LAKOTA NATION POST SECONDARY STUDENT DIRECT DEPOSIT FORM Name: ____________________________________________________ Address: __________________________________________________ Telephone: ________________________________________________ Name of Bank: _____________________________________________ Bank Address ______________________________________________ ______________________________________________ _______________________________________________ Bank Phone: (_____)__________________________________________ Transit #: _____________________________ (Must be 5 digits) Bank #: _______________________________ (Must be 3 digits) Account # __________________________________________________ Type of Account (savings, chequing, other): _______________________ I hereby authorize the Wood Lakota Nation Chief and Council to directly deposit to my account as noted above. ___________________________________ _______________________ Signature Date Exit Document Form Name: _______________________________________________________ First Last Middle Date of Registration: _____________________Finishing Date: Reason for leaving the program: (please check one of the boxes below) Graduated Medical ProblemsOther RelocationChildcare Issues Financial IssuesEmployment Comments: Wood Mountain Lakota Nation Post Secondary Policy Page PAGE \* MERGEFORMAT 40 ) + : @ B U W ! 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