Higher Education Application Page 4 of 4 App. Amended November 2019
NATIVE VILLAGE OF BARROW FUNDING AGREEMENT FORM
Phone: (907) 852-4411 Fax: (907) 852-8844 Mail: PO Box 1130 Barrow, Alaska 99723 E-Mail: workforce@nvbarrow.net
I, ________________________________________, have read the Scholarship Grant Policies and Procedures. I
understand that these funds are supplemental funds. I affirm that I have sought other funding resources to help
fund my educational training needs listed below:
Semester: ○ Spring ○ Summer ○ Fall Year: ___________________
Name of Accredited Institution
______________________________________________________________________________
Address City State Zip Code
Please attach your student schedule/class registration with credits.
By signing this document I certify that I fully understand that if in the event that I do not complete the semester by dropping out or
withdraw, that I must return the awarded amount back to Native Village of Barrow, furthermore, I understand that this can affect my
future financial assistance requests for financial aid scholarship.
I also understand that if I do not return these funds I will not be awarded Higher Educational funds until all past due funds are returned
to Native Village of Barrow.
DROP OR WITHDRAWAL
1. All awarded funds will need to be reimbursed back to the Native Village of Barrow if a student decides to drop out of courses
and does not complete the semester.
2. If student fails to have funds reimbursed to Native Village of Barrow student will not be awarded for future funds.
3. Native Village of Barrow will be billing the student.
_______________________________ ____________________
Signature of Student Date
________________________________ ______________________
Signature of Workforce Staff or Director Date
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