Fillable Dear Ho-Chunk Student, The Higher Education Division is (Ho-Chunk Nation)

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Dear Ho-Chunk Student, The Higher Education Division is (Ho-Chunk Nation)

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P.O. Box 667, Black River Falls, WI 54615 • 800-362-4476 • e-mail: higher.education@ho-chunk.com • Fax: 715-284-1760
p.1
Dear Ho-Chunk Student,
The Higher Education Division is committed to helping you attain your educational and professional goals. In
order to be considered for a Ho-Chunk Scholarship, you must meet the following requirements:
• Be an enrolled Ho-Chunk member;
• Be interested/accepted/enrolled in pursuing a progressive degree at an accredited Title IV non-profit
institution of higher learning (subject to approval);
• Properly file a Free Application for Federal Student Aid (FAFSA) each academic year;
• Complete the Ho-Chunk Scholarship Application prior to the absolute deadline (first day of classes).
Funding maximums are determined by type of degree program you are interested in and are prorated for part-
time attendance. Funding is determined by standard semester terms, students pursuing coursework online, night
classes, or attending quarter based schools; for these particular institutions, your terms will be calculated into an
equivalent semester ratio.
The following is needed to complete the funding process: Timeline
1. Ho-Chunk Scholarship Application (HSA) Complete one
application each academic year
Submit an HSA early to allow for
processing time
Academic Year includes both fall and spring terms; Applications will not be processed after the absolute deadline (first day of classes)
2. File the Free Application for Federal Student Aid (FAFSA)
File and/or update online annually at
www.fafsa.gov
3. Acceptance Letter: Technical/two-year campus students
Admission Letter: Four year and graduate students
As soon as possible
4. Submit a copy of your class schedule, include your name,
academic term, school name, and number of credits
As soon as you register
5. Submit a copy of the school’s itemized billing statement As soon as it is posted to your account
6. Submit a copy of your Financial Aid Award Summary
provided by the school
As soon as it is posted to your account
7. Official transcript *Only students who previously received
funding
As soon as grades are posted for term
8. Submit a copy of your Certificate Degree of Indian Blood
(CDIB)
As soon as possible
Funding of Last Resort Clause: Full-time students accepted into a four year program, and determined by the school’s
Financial Aid Office as “need-based”, may require some original documents due to federal funding source.
You may find the Higher Education Operating Policy and more program information on our webpage:
http://edu.ho-chunknation.com/highered or E-mail us at: higher.education@ho-chunk.com.
Academic Year 2020-2021
P.O. Box 667, Black River Falls, WI 54615 • 800-362-4476 • e-mail: higher.education@ho-chunk.com • Fax: 715-284-1760
p.2
As a parti
cipant in the Ho-Chunk Nation Scholarship Program:
1. I agree that participation in this program is strictly voluntary; once an award is used, I
acknowledge my requirement to abide by the minimum qualifications of the scholarship. I further
understand violations may result in repayment of the award in full.
2. I hereby acknowledge that I have read and fully understand the rules, terms, and conditions of the
Higher Education Scholarship Operating Policy and agree to abide by said rules, terms,
and conditions of the policy and scholarship award letter. The current academic year
Higher Education Division Funding Policy is located at http://edu.ho-chunknation.com/
highered.
3. I understand that my failure to comply with all such rules, terms and conditions, currently existing
or as amended or modified in the Higher Education Division Operating Policy, may result
in probation, suspension and/or a financial obligation that is my responsibility.
4. I understand and agree if I withdraw, drop out, or am expelled from any classes, or if I reduce the
initial number of credits, or classes taken, I must provide written notification to the Higher
Education Division immediately as funding may result in the return of scholarship funding to the
Ho-Chunk Nation Higher Education Division. I further understand that failure to do so may result
in my probation, suspension and/or a financial obligation that is my responsibility.
5. If applicable, I understand that it is my responsibility to report the value of my Per-Capita Trust
Fund(s) when I complete my FAFSA.
6. I understand that the Ho-Chunk Nation assumes no responsibility and no liability for any effects
that the Scholarship Program may have on any other funding anticipated or actually received by
the participant, including but not limited to; Welfare, Social Security, Supplemental Security
Income (SSI), Medicare, or other grants, scholarships and/or fellowships provided by any private,
state, or federal entities currently existing or created in the future.
7. I acknowledge that the funding process may take several weeks to complete, and that it is in my
best interest to apply early. I understand that the Ho-Chunk Scholarship I am applying for cannot
be processed until all supporting documents have been submitted by me.
8. I further acknowledge my financial responsibility for school fees and charges until awarded
and sent to the school.
9. I understand and agree that funds may be returned due to changes in my enrollment status or
failure to maintain Satisfactory Academic Progress (SAP).
10. I understand my tax filing responsibility to claim all per-capita payments I receive from the Ho-
Chunk Nation on my taxes and FAFSA each year.
Student Rights and Responsibilities
Academic Year 2020-2021
Highered Education Division Operating Policy is located at http://edu.ho-chunknation.com/highered
Ho-
Chunk Nation Scholarship Application
P.O. Box 667, Black River Falls, WI 54615 • 800-362-4476 • e-mail: higher.education@ho-chunk.com • Fax: 715-284-1760
p.3
439A00-
Tribal ID Number
Legal Last Name
MI
Previous/Maiden name/AKA
- -
/ / □ Male □ Female □ Other □ Phone □ E-mail □ Mail
Social Security Number
Date of Birth (MM/DD/YY)
Preferred Communication
Mailing Address (while attending school)
City
State
Zip
Permanent Address (if different from mailing address)
City
State
Zip
( ) -
Primary Phone Number
Print E-Mail
/
FAFSA Filing Date (MM/YY) College/University you will attend College/University Location: City/State
Completion of 2018 Income Tax Filing? □ Y □ N
(Includi
ng per-capita payments)
Marital Status Number of Dependents
Previous Higher Ed funding received: □ Y □ N List Years: _______________________________________________
I have read and agree to the Ho-Chunk Nation Higher Education Operating Policy, Student Rights and Responsibilities, which
include my responsibility to file the appropriate taxes on my Ho-Chunk Nation per-capita payments and trust fund(s) listed on
page (2). I acknowledge my responsibility for payment of all school charges and fees until my scholarship has been
determined, awarded, and sent to the school. I further acknowledge scholarship funds may be returned due to changes in
enrollment status or failure to maintain Satisfactory Academic Progress (SAP).
□ Y □ N
Parental Information:
Father’s Name: __________________________________________________ Tribal Affiliation: ________________________________
Mother’s Maiden Name: ___________________________________________ Tribal Affiliation: ________________________________
Student Consent & Release of Information:
The information given by me on this form is accurate and complete to the best of my knowledge. By signing this application I am
granting permission for my post-secondary institution or my prospective institution to share my information, including
STUDENT FAFSA RECORD INFORMATION to the Ho-Chunk Nation Higher Education Division. I give permission for my
financial aid and academic information to be shared among the following funding agencies: Bureau of Indian Affairs, Ho-Chunk
Nation, State, the Financial Aid Office, and Academic Advisors at my school. I understand I may be required to complete a
separate release of information for any additional inquiries.
_______________________________________ ______________________________________ __________________
Student Signature Student’s Legal Name (printed) Date
Academic Year 2020-2021
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signature
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P.O. Box 667, Black River Falls, WI 54615 • 800-362-4476 • e-mail: higher.education@ho-chunk.com • Fax: 715-284-1760
p.4
Student Profile
To better suit your educational needs, we want to know more about you. Please tell us about your education goals.
Secondly, what are your career goals upon degree completion?
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
Number of Credits Earned in Intended Degree:
□ Freshman 1-30 □ Sophomore 31-60 □ Junior 61-90 □ Senior 91-120 □ Graduate # cr. _______
Current Degree Program:
□
Technical Diploma/Certificate
□
Associate
□
Bachelor’s
□
Master’s
□
Juris /Doctorate
□
Doctorate
Program/M
ajor :
Expected Graduation Date: ___________
Double Major/Minor:
Credits Needed to Graduate: __________
Other Benefits/Employment:
U.S. Veteran: □ N □ Y Military Benefits: □ State □ Federal □ Military Discount □ Parent/Spouse □ N/A
Present Employment:
Em
ployed: □ N □ Y Work Status While Attending School: □ Full-time □ Part-time □ N/A
Current Ho-Chunk Nation Employee: □ N □ Y D
epartment:
Division:
I
am interested in receiving information on the following:
□ Academic Advising □ Financial Advising □ Disability Services/Accommodations
□
Internship Opportunities □ Study Abroad □ Ho-Chunk Nation Employment
I understand that it is my responsibility to report changes regarding my contact information (address, phone, and e-mail),
enrollment status, and changes to my financial aid to the Higher.education@ho-chunk.com student e-mail.
_________
____________________________ ______________________________________ ______________
Student Signature Student’s Legal Name (printed) Date
Academic Year 2020-2021
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Dear Ho-Chunk Student, The Higher Education Division is (Ho-Chunk Nation)

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Completed 23 December 2020

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