MontanaUniversitySystem
AmericanIndianTuitionWaiver
Application
Financial Aid
Montana State University - Northern
300 West 11
th
Street
Havre, MT 59501
Ph: 406.265.3787
Fax: 406.265.3519
www.msun.edu/finaid

QUALIFICATIONS:
1. YoumustbearesidentoftheStateofMontanawhenyouenrollinoneofthetwoorfouryearcollegesoftheMontana
UniversitySystem.
2. YoudemonstratefinancialneedasdefinedbyBoardofRegentsPolicy940.13(F)(4)bycompletingtheFreeApplicationfor
Federal
StudentAid(FAFSA).YoumustcompleteandsubmittheFAFSAeachacademicyearyourequestthistuitionwaiver.
3. Selectatleastoneofthefollowingoptions:
Iamatleastonequarter(1/4)degreeofIndianbloodandIwillprovideacopyofmyCertificateofIndianBlood
(letter/card).
Iamatleastonequarter(1/4)degreeofIndianbloodandIwillprovideproofofdescentusingbirthcertificatesand/or
lettersfromTribalofficials.
IamanenrolledmemberofastateorfederallyrecognizedIndianTribewhichislocatedwithintheboundariesofthe
StateofMontanaandIwillprovideacopyofmyTribalEnrollmentCard.
StateorFederallyRecognizedTribesLocatedwithintheBoundariesofMontana*
Assiniboine
Blackfeet
ChippewaCree
Crow
GrosVentre
Kootenai
LittleShellChippewa
NorthernCheyenne
Pendd’Oreille
Sioux
Salish
LIMITATIONS:
1. TheAmericanIndiantuitionwaiveronlywaivestuition.Feesnotcoveredbythiswaiverareyourresponsibility.
2. Thiswaivercannotbeusedinconjunctionwithotherstatetuitionwaivers.
3. Thewaiverwillcontinueaslongasyoumaintainsatisfactoryacademicprogressaccordingtothestandardsofthe
FinancialAidOfficeatthecollegeyouattend.
Name:_______________________________________________________TribalEnrollmentNumber:_________________
Address:________________________________________City:_______________________State:_______Zip:__________
Telephone:_____________________________________Email:_________________________________________________
g
NameofYourTribe:____________________________________________________________________________________
Address:_________________________________________City:_______________________State:_______Zip:__________
Telephone:_____________________________________EmailorWebsite:_______________________________________
________________________________________ __________________ ____________________________________
SignatureDate SocialSecurityNumberorStudentID
MSUNortherndoesnotdiscriminateonthebasisofrace,color,nationaloriginal,sex,ordisability.

PROOFOFINDIANDESCENTAND/ORTRIBALENROLLMENTMUSTACCOMPANYTHISFORM
Oncethisformiscompletedandapproved,youdonotneedtocompleteitagain,aslongasyouremaincontinuouslyenrolledatthis
campusandyoumaintainsatisfactoryacademicprogress.
*Forafulllistofrecognizedtribes,visit:http://www.ncsl.org/issuesresearch/tribal/listoffederalandstaterecognizedtribes.aspx#mt
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