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CITC Scholarship Application
I am a new student only who has never applied before or last
applied over 3 years ago. If you are a new student please provide a copy of your
GED or
Fall 2015 Application Deadline:
Final High School Transcripts
I am a continuing student who last applied within three (3) years
or I applied for the Spring 2015 scholarship award.
Personal Information
Student Name: (First, Middle Name, Last)
Gender:
Male
Female
Home (permanent) address:
Other Full Names Used:
Date of Birth:
Social Security #:
Mailing Address:
Same as Home address
Work Phone:
Cell Phone:
Email Address:
School Email Address:
Academic Information
Classification Year
May 31, 2015
Applications accepted by email, fax,
postal service, or by scheduled
appointment.
Freshman (0-29 credits)
Senior (95+ credits)
Home Phone:
Sophomore (30-59 credits)
Graduate
Junior (60-94 credits)
Field of Study / Name of Degree:
Transcripts and Credits
I am going to school: Begin Date: _____________ End Date: ______________
Fall
Spring
Summer
Part Time
Full Time
(Mo/Yr)
(Mo/Yr)
(6+ credits) (12+ credits)
Graduation Date: _______________ (month/day/year)
Eligibility
My Regional ANCSA Corporation(s) is:
Ahtna
Aleut
ASRC
BSNC
BBNC
Calista
Chugach
(Check all that apply)
CIRI
Doyon
Koniag
NANA
Sealaska
13th Region
Other
I am an Alaska Native Shareholder
or Descendant
I am a Tribal member of the following Cook Inlet Region village:
Chickaloon
Tyonek
Ninilchik
Kenaitze
Knik
Salamatof
None:
Financial Aid Information
Name of school you are attending/enrolled in:
Financial Aid Office: (Mailing Address, City, State, Zip)
Financial Aid Counselor:
Financial Aid Telephone:
Financial Aid Counselor’s Email Address:
Financial Aid Fax:
I am receiving other Scholarships
Yes
If Yes, please list which scholarships:
Education Status
Financial Aid Website
Address:
No
Name of School
Degree:
Date:
Secondary Education
I understand that by signing below, I certify the information is true, correct and complete to the best of my knowledge.
I understand that any deliberate false statements are subject to grounds for immediate withdrawal of my application.
Student Legal Name:
Student Signature:
Social Security Number:
Date:
For application questions or assistance, please schedule an appointment by contacting [email protected] or 907-793-3263.
Cook Inlet Tribal Council, Inc.
907-793-3466 Fax
ATTN: Scholarships
3600 San Jeronimo Drive, 4th Floor Reception
http://citci.org/education/scholarships/
Anchorage, AK 99508
~ Updated as of 4/27/15~
~ For Office Use Only – Dates Stamp Area ~
CITC Scholarship Application
Scholarship Documents Fall 2015
(THE) Tribal Higher Education Scholarship Checklist
Completed and signed application
Proof of Alaska Native/American Indian (AN/AI) Blood or Certificate Degree of Indian Blood (CIB/CDIB) or
Proof of Tribal Enrollment
CIRI Documentation (CIRI shareholder or direct lineal descendent documentation)
CITC Authorization to Obtain Personal Information
CITC Authorization to Release Personal Information from CITC
CITC Authorization to Obtain/Release Personal Information Within CITC
CITC Intake Form (new scholarship applicants and/or change in personal information)
CITC Client Grievance Policy & Client Acknowledgement Statement
Official Transcripts noting cumulative GPA (THE - must maintain a minimum cumulative GPA of 2.0)
Acceptance Letter or Academic Program Change
Other funding sources
Cook Inlet Region Tribal Affiliation Relevant Award Letters and/or Denial letter for Tribal funding
Reference Letter (from a non-family member)
Current Class Schedule
Budget Forecast (available from your school)
Student Aid Report (SAR) –obtain free from Federal Application for Student Aid (FAFSA)
(If you are not filling out a FAFSA, please complete the attached Financial Disclosure Form.)
Proof of Selective Service Registration (male students 18-25 years of age)
For application questions or assistance, please schedule an appointment by contacting [email protected] or 907-793-3263.
Cook Inlet Tribal Council, Inc.
907-793-3466 Fax
ATTN: Scholarships
3600 San Jeronimo Drive, 4th Floor Reception
http://citci.org/education/scholarships/
Anchorage, AK 99508
~ Updated as of 4/27/15~
~ For Office Use Only – Dates Stamp Area ~
CITC Scholarship Application
Scholarship Documents Fall 2015
(AM) Alyeska Match Scholarship Checklist
Completed and signed application
Proof of Alaska Native (AN) Blood or Certificate Degree of Indian Blood (CIB/CDIB) or Proof of Tribal
Enrollment
AM Student Information Release & Attestation
Applicant EEO
Student Resume
Official Transcripts noting cumulative GPA (AM - must maintain a minimum cumulative GPA of 2.5)
Degree/Certification program curriculum & completion dates
Personal statement of career goals/statement of purpose
Other funding sources (notice of other scholarships (not CITC), or funding from any other Alyeska sources (i.e.
Internships, scholarships)
Based on the Grant file these are the eligible career fields
Engineering:
Electrical, Mechanical, Civil, chemical/Process
Business:
Management Information Systems, Technology,
Engineering Management, Environmental Quality
Engineering/Science, Project management,
Construction Management, Project Controls
Environment:
Biology, Chemistry
Planner / Scheduler:
Accounting, Finance, Economics, Math/Statistics –
Engineer Majors
Quality Assurance / Inspection Professionals / Project
Managers:
Please see Engineering, Safety, and Business Majors
Technical:
Process Technology, SCADA, Instrument, Welding
For application questions or assistance, please schedule an appointment by contacting [email protected] or 907-793-3263.
Cook Inlet Tribal Council, Inc.
907-793-3466 Fax
ATTN: Scholarships
3600 San Jeronimo Drive, 4th Floor Reception
http://citci.org/education/scholarships/
Anchorage, AK 99508
~ Updated as of 4/27/15~
~ For Office Use Only – Dates Stamp Area ~
CITC Scholarship Application
Document Descriptions and Forms for
Tribal Higher Education Scholarship (THE)

Proof of Alaska Native/American Indian (AN/AI) Blood – Available from the Bureau of Indian Affairs
(BIA) office at http://www.bia.gov/WhoWeAre/RegionalOffices/Alaska/ This can be in the form of your
Certificate Degree of Indian Blood (CDIB or CIB) or Tribal Enrollment Documentation if that
document verifies that you are AN/AI. Only 1st time applicants need to submit.

CIRI documentation – Documentation that you are an original enrollee, or direct lineal descendent of an
original enrollee in Cook Inlet Region Incorporated (CIRI) – Available from CIRI Shareholder Relations:
(907) 263-5191, toll free (800) 764-2474, or via email at [email protected]. Please note, we
can either accept a CIRI enrollee card, a enrollee descendent card, or a letter from shareholder relations
certifying your status. As another option, you can demonstrate your descendent status by showing the
original shareholder's CIRI enrollment card and a document, such as your birth certificate or marriage
certificate that shows that you are the shareholder's descendant. Only 1st time applicants need to submit.

Release of Information forms
o CITC Authorization to Obtain Personal Information
o CITC Authorization to Release Personal Information from CITC
o CITC Authorization to Obtain/Release Personal Information within CITC

CITC Intake Form – Only need to submit if you are a new applicant, or have changes in your personal
information since last submitted.

Client Grievance Policy Acknowledgement Statement

Official Transcript/Most current official transcript noting cumulative GPA (you must have and maintain
a minimum cumulative GPA of 2.0 to apply and be eligible for the Tribal Higher Education Scholarship) –
Available from your school’s office of the registrar. If you cannot supply an official transcript, we can accept
a version printed from your school's on-line system if it is signed and witnessed in person by a CITC
employee. If college transcripts are not yet applicable, high school transcripts may be provided.

College Acceptance letter or Academic Program Change – Letter from your school granting you
admission; proof of admission or program change.

Other funding sources – need to provide notice of other scholarships.

Cook Inlet Region Tribal Affiliation Award/Denial letter for tribal funding – Applicants who are
enrolled in a Cook Inlet region Tribe (Chickaloon, Eklutna, Kenaitze, Knik, Ninilchik, Salamatof, Seldovia, or
Tyonek) must apply for that Tribe's scholarship program prior to applying for CITC's scholarship. You will
only be eligible for the CITC scholarship if you are denied by the tribe you are enrolled in. You need to
provide verification of the denial of the scholarship funding from your Tribe in order to be eligible for CITC
funding.
-Continued on next page
For application questions or assistance, please schedule an appointment by contacting [email protected] or 907-793-3263.
Cook Inlet Tribal Council, Inc.
907-793-3466 Fax
ATTN: Scholarships
3600 San Jeronimo Drive, 4th Floor Reception
http://citci.org/education/scholarships/
Anchorage, AK 99508
~ Updated as of 4/27/15~
~ For Office Use Only – Dates Stamp Area ~
CITC Scholarship Application

Reference letter from a non-family member – Letter recommending you as a good candidate for college,
with the skills and desire to complete your degree program and college goals. This can be from a teacher,
counselor, supervisor or any non-relative who can speak to your academic potential. For your reference,
see the sample letter below.
Sample letter of recommendation
To Whom It May Concern:
I have known Your Name for the past two and a half years, having served as her teacher in both English and Arts at ________ High
School. I believe that Your Name is very well suited for higher education. Your Name is a bright and attentive young person. In
class and in her work, she demonstrates that she is an intelligent and capable student with great potential. I am confident that she
will thrive in any academic program that she chooses to pursue. I am convinced that Your Name would make a more than
valuable contribution to your university. She has my highest recommendation. Should you have any questions, please do not
hesitate to contact me.
Sincerely,
Name of Non-Relative
Teacher, _______ High School

Current class schedule – Available from your school’s office of the registrar or via your online student
portal.

Budget Forecast - Available from your school’s financial aid office or via your online student portal. This
may also be called Financial Need Sheet, Cost Information Sheet, or Statement of Student Account. At a
minimum, your budget forecast needs to show the cost of your academic program (tuition, fees, books,
room and board) and your other sources of income (other scholarships, loans, parental support, etc.)

Student Aid Report (SAR) obtain free from Federal Application for Student Aid (FAFSA). You must apply
for financial aid through the FAFSA program to be eligible. This will result in a SAR. Your SAR is viewable
by clicking Login on the FAFSA on the Web home page. Next select either the PDF or HTML version of the
SAR from the “My FAFSA” page: https://fafsa.ed.gov/. If you are not filling out a FAFSA, please complete
the Financial Disclosure Form

Proof of Selective Service registration – required for male applicants between the ages of 18-25.
Available here: https://www.sss.gov/regver/wfverification.aspx
For application questions or assistance, please schedule an appointment by contacting [email protected] or 907-793-3263.
Cook Inlet Tribal Council, Inc.
907-793-3466 Fax
ATTN: Scholarships
3600 San Jeronimo Drive, 4th Floor Reception
http://citci.org/education/scholarships/
Anchorage, AK 99508
~ Updated as of 4/27/15~
~ For Office Use Only – Dates Stamp Area ~
CITC Scholarship Application
Document Descriptions and Forms for
Alyeska Match Scholarship (AM)

Proof of Alaska Native (AN) Blood – Available from the Bureau of Indian Affairs (BIA) office at
http://www.bia.gov/WhoWeAre/RegionalOffices/Alaska/ This can be in the form of your Certificate
Degree of Indian Blood (CDIB or CIB) or Tribal Enrollment Documentation if that document verifies
that you are AN. Only 1st time applicants need to submit.

Alyeska Student Information Release & Attestation

Alyeska Applicant EEO

Current Student Resume Document briefly outlining work and academic skills and experiences

Official Transcript/Most current official transcript noting cumulative GPA (you must have and maintain
a minimum cumulative GPA of 2.5 to apply and be eligible for the Alyeska Match Scholarship) – Available from
your school’s office of the registrar. If you cannot supply an official transcript, we can accept a version
printed from your school's on-line system if it is signed and witnessed in person by a CITC employee. If
college transcripts are not yet applicable, high school transcripts may be provided.

Degree/Certification program curriculum and estimated completion dates –Outline or certification of
program curriculum and graduation dates. Available from your school’s administration, usually the office of
the registrar, or through your on-line student portal.

Personal statement of career goals/Statement of Purpose – 250-300 word statement identifying your
professional goals.

Other funding sources – need to provide notice of other scholarships or funding (not CITC), or from any
other Alyeska sources (i.e. Internships, scholarships).
For application questions or assistance, please schedule an appointment by contacting [email protected] or 907-793-3263.
Cook Inlet Tribal Council, Inc.
907-793-3466 Fax
ATTN: Scholarships
3600 San Jeronimo Drive, 4th Floor Reception
http://citci.org/education/scholarships/
Anchorage, AK 99508
~ Updated as of 4/27/15~
~ For Office Use Only – Dates Stamp Area ~