Nebraska Indian Community College
APPLICATION FOR ADMISSION The following are needed to complete the admissions process: 1) Completed application 2) Signed Declaration of Major 3) $10 admission fee if cash paid up front, $50 if billed 4) Catalog Acknowledgement 5) Official high school or GED transcript 6) Certificate of tribal enrollment, if applicable
7) Official college transcript for transfer credits 8) Complete FAFSA at www.fafsa.ed.gov 9) Complete scholarship application @ www.collegefund.org
If you have any questions please contact Student Services for assistance. Contact the Financial Aid Office for financial aid information/questions. (Office ID#_____________)
PLEASE PRINT CLEARLY Application Status: (Circle One) Campus: (Circle One)
New
Transfer
Macy
Audit
Santee
Other
South Sioux City
_________________________________________________________/____-_____-_____ Last Name
First
Middle
Maiden
Social Security #
_________________________________________________________________________________________ Street/P.O. Box City County State Zip Code Telephone Number(s) Home: _____-_____-_____ Work: _____-_____-_____ Cell: ______-______-______ E-mail Address: _____________________________________ Are you a U.S. Citizen? Yes ____ No____
If not explain: ___________________________________
Legal resident of which state: ___________
Are you a Veteran? Yes ____ No____
Are you a First Generation student? Yes____ No____ Date of Birth: ______________ (Month/Day/Year)
Are you a Low Income student? Yes____ No____
Gender: Male____ Female____
Marital Status:________
The following information is requested so we may demonstrate to the Department of Education this institution’s compliance with the Title VI of the 1964 Civil Rights Act. Your response is voluntary: Race: ____________ Tribe (if applicable): _______________ Enrollment Number: ______________ Are you eligible for Veteran’s Benefits, Tribal Higher Education, AmeriCorps or other Tuition Waivers or High School Scholarships? YES NO Please define the source: ________________________________ Are you planning to attend FULL Time (12 or more credit hours)
Did you complete a Head Start Program
Yes
or
PART Time (11 or less)?
No
High School (HS): ___________________________________________________________________________ (Last or current) Institution Name City State Graduation Date (Mo/Yr) If you did not graduate from HS, where did you complete your GED diploma GED: ______________________________________________________________________________________ Institution Name City State Completion Date (Mo/Yr) M a c y
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Nebraska Indian Community College List all colleges, universities, technical and trade schools that you have attended? Specify any previous degree, diploma- certificate- conferred/major: (Please include degrees obtained from Nebraska Indian Community College in list.) Name: ____________________________________________________ City/State: _____________________________ From:___________ To: ___________ Education/Certification/Degree: __________________________________ Name: _____________________________________________________City/State: _____________________________ From:___________ To: ___________ Education/Certification/Degree: __________________________________
**If you intend to transfer current credits held by other institutions to NICC – you MUST request official documentation to be mailed to Registrar at PO Box 428, Macy, NE 68039 What are activities you want to experience in college?_______________________________________________ ____________________________________________________________________________________________________________
________________________________________________________________________________________________ ________________________________________________________________________________________________
Please provide us with one emergency contact:
How did you hear/decided to attend NICC? circle one of the following.
Name: _______________________________________
Convenient Location
Family
Address: _____________________________________
Newspaper ad
Friend
Postcard/Mailing
Radio
NICC Alumni
Poster
_____________________________________ Telephone Numbers: Home: ___________________ Cell: ___________________ Work: ___________________
High School Counselor Other ____________________________
Relationship: ________________________________
I certify all the information I have given in this application is complete and accurate to the best of my knowledge, and if admitted, I agree to observe all the rules and regulations of Nebraska Indian Community College. I understand that I am responsible for the information in the current college catalog which can be found online at www.thenicc.edu or through Student Services. I acknowledge that NICC will be allowed to use activity photographs taken of me participating in school events for marketing or other business related purposes. Signature: _____________________________________________ Date: ___________________________________
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Nebraska Indian Community College
DECLARATION OF MAJOR PLEASE PRINT CLEARLY
Campus: (Circle One)
Macy
Santee
South Sioux City
_______________________________________________________________/____-_____-____ Last Name
First
Middle
Maiden
Social Security #
________________________________________________________________________________________________ Street/PO Box City County State Zip Code
Note: Select only one (1). DEGREE AND MAJOR: ___ Associate of Arts – General Liberal Arts (AA-GLA) ___ Associate of Arts – Business Administration (AA-BUS)
___ Associate of Arts – Native American Studies (AA-NAS) ___Associate of Arts – Human Services (AA-HS) ___ Associate of Arts – Early Childhood Education (AA-ECE) ___Associate of Science – Science Studies (AS-SS) ___Associate of Applied Science – Carpentry (AAS-CPT)
___Enrichment ___Transfer credit to Another College ___ Dual Credit
CERTIFICATE: ___Carpentry (CERT-CPT) EXPECTED DATE OF COMPLETION: SEMESTER______
YEAR ______
Any change in this plan is to be discussed with an advisor or counselor and a new Declaration of Major form needs to be completed and forwarded to the Registrar’s Office. _____________________________________ Signature
_____________________________ Date
______________________________________ _____________________________ Advisor Date
OFFICE USE ONLY: Inputted into Empower by _____ on ___________
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Nebraska Indian Community College (Student Copy) Academic Standing pg.36-37 in College Catalog Criteria 1: Grade Point Requirements (Qualitative): Each student who receives Federal financial aid must have at least a minimum cumulative Grade Point Average (GPA) of 2.0 or as defined by their student classification. See pages 20-21 and 36 of the college catalog. Criteria 2: Course Completion Requirements(Quantitative): The student is eligible for financial aid when they successfully earn with a passing grade of A, B, C, D, or P at least 67% of the cumulative attempted credit hours per term. A grade of F, IW, W, UF, or I, is considered an unsuccessful grade. Refer to additional Academic Progress on page 36 in the college catalog. Payment of Awards All required admission and financial aid documentation must be complete and on file before any financial aid can be disbursed. Each student's financial aid is credited to his or her student account in the Business Office in the order received. All institutional charges, including tuition, fees, books, materials, and supplies are deducted from the financial aid award(s). If a student's financial aid exceeds institutional charges, the student will receive a refund. College students will receive their financial aid in up to two disbursements per term. Disbursements will occur after the census date, attendance is documented, and if the student is in good academic standing. Nonth federal funds will be awarded the 10 week. If you have questions regarding your educational path please contact the appropriate office as listed below: Admissions:
Marcia Robertson – Macy Campus X2589 Troy Munhofen – South Sioux City Campus X2586 Chrissy Lesher – Santee Campus X2573
Transcripts:
Annette Loche, Registrar
Financial Aid:
Cecilei Pappan, Financial Aid Director
Student Billing: Laura McCaulley, Student Billing Clerk Any other concerns related to your education: Dawne Price, Dean of Student Services X2582 or Don Torgerson, Academic Dean X2572
Official Transcripts should be mailed to: Nebraska Indian Community College Registrar PO Box 428 Macy, NE 68039
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