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MUSCOGEE (CREEK) NATION

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MUSCOGEE (CREEK) NATION
SPECIAL ACADEMIC/EXTRA-CURRICULAR
ACADEMIC ACTIVITIES
NCA 00-136 GRANT
INFORMATION SHEET
PLEASE READ CAREFULLY
: Applicants MUST complete this application and submit all requested documentation.
Incomplete applications will NOT be considered.
NCA 00-136 is designed to address the needs Muscogee (Creek) students who have exhausted all
other funding sources to meet their need and WHO ARE NOT RECEIVING ANY TYPE OF FINANCIAL
ASSISTANCE FROM ANY OTHER TRIBAL EDUCATION PROGRAM FOR THIS SPECIFIC NEED.
GRANT INFORMATION:
1. The NCA 00-136 Grant will assist eligible students with approved needs ONE TIME, that may range up to
a maximum of $500 based on financial need. Special Academic & school related Extra-Curricular
activities.
2. This grant is SUPPLEMENTAL financial assistance and should not be seen as the total funding source for
any specific need.
3. We do not do reimbursements.
4. The Recipient will be required to sign a statement that all receipts will be submitted to the reviewing
committee within two (2) weeks of the grant being utilized. Funds must be used for the purpose
approved by the reviewing committee.
5. The Grant Award is non-transferrable and must be utilized by the applicant for approved need only.
6. If funds are not used in the manner approved by the reviewing committee those funds are subject to be
repaid by the recipient.
7. The Reviewing Committee has full discretionary authority in the administration of these funds.
8. If selected as a grant recipient, you will be notified by mail or/ phone from the Grant staff.
GRANT REQUIREMENTS: REQUIRED
1. Complete application (attached)
2. Copy of applicants MUSCOGEE (CREEK) NATION CITIZENSHIP card
3. Letter of acceptance or appointment from the academic organization (Special Academic), school
sponsored educational or school sponsored athletic organization (Extra-Curricular)
4. A short (printed or typed) statement explaining your need
5. A budget breakdown:
a. Expenses being incurred by the student (e.g., tuition, textbooks, on-campus housing costs)
b. The amount of funds being requested
c. Listing of funds raised by the student to assist in this endeavor (money you made from job, or
donated to you)
6. Letter(s) of denial from alternative funding source(s) (letter from financial aid, bank, etc.)
Mail Application to: Muscogee (Creek) Nation
Department of Education & Training
ATTN: NCA 00-136 Grant
P.O. Box 580
Okmulgee, OK 74447
For Additional Information Contact the Department of Education&Training at: 918.732.7727 or 918.732.7741
E-Mail to: shwahnee@mcn-nsn.gov
08/05/2019
NCA 00-136 GRANT APPLICATION
(MUST BE COMPLETED IN FULL TO BE CONSIDERED)
DATE
NAME SOCIAL SECURITY # - -
D.O.B / / SCHOOL GRADE
HOME ADDRESS
STREET CITY STATE ZIP
HOME/CELL PHONE ( ) WORK PHONE ( )
EMAIL:
Contact Person’s Name Representing School or Organization:
PHONE (
)
Dates
of Activities for the Funds:
NAME
Amount of Funds Being Requested: $
DEADLINE IF ANY, for activity payment:
IF YOUR GRANT IS APPROVED THE CHECK WILL BE MADE PAYABLE AND MAILED TO:
SCHOOL/ORGANIZATION/COMPANY:
ATTN:
ADDRESS:
CITY STATE ZIP
Please fill out and sign below. Eligible applicants under the age of 18 must have a parents/guardian’s consent and signature.
I/We,
, have read and understand the eligibility requirements of this grant from the
Muscogee Creek Nation, NCA 00-136. I certify that all information provided is current and complete, including attachments.
I/We affirm that the proceeds of this grant, as authorized under the Department of Education and Training and in ordinance per
the Muscogee (Creek) Nation Legislation 2000 NCA 00-136, will be used solely for the purpose approved by the reviewing
committee or will be subjected to repayment. I guarantee that I will deliver all receipts to the reviewing committee within two (2)
weeks of the grant being utilized.
Student or Parent/Guardian Signature Date
Check List:
Completed Statement of Need
Budget Breakdown
Completed Application
Copy of Citizenship Card
Acceptance Letter/ Class Schedule
Letter(s) of Denial
NCA 00-136 GRANT REVIEWING COMMITTEE USE ONLY
APPLICATION RECEIVED DATE: BY:
Date of Review:
Review Team Members:
E&TA
; JOM
____;
H ED.
; GA ;
Approved for assistance: YES NO
Amount to be awarded: $
*Reason for Denial:
Grant Assistance
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MUSCOGEE (CREEK) NATION

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Completed 1 February 2022

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