Page 1

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

S a n t e e

S o u t h

S i o u x

(NICC REVISED FALL 2013)

C i t y

1


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: ___________________________________

M a c y

S a n t e e

S o u t h

S i o u x

(NICC REVISED FALL 2013)

C i t y

2


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 ___________

M a c y

S a n t e e

S o u t h

S i o u x

(NICC REVISED FALL 2013)

Empower ID # _________________

C i t y

3


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

M a c y

S a n t e e

S o u t h

S i o u x

(NICC REVISED FALL 2013)

C i t y

4


[Title will be auto-generated]  

http://www.thenicc.edu/images/pdfs/studentapplication1.pdf

Advertisement
Read more
Read more
Similar to
Popular now
Just for you