Fillable Pokgnek Bodwadmik Financial Aid Verification (FAV) Form Part (Pokagon Band of Potawatomi Indians)

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Pokgnek Bodwadmik Financial Aid Verification (FAV) Form Part (Pokagon Band of Potawatomi Indians)

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Pokégnek Bodéwadmik
POKAGON BAND OF POTAWATOMI
EDUCATION
58620 Sink Road • PO Box • Dowagiac, MI 49047 • www.PokagonBand-nsn.gov
(269) 782-0887 • (888) 330-1234 toll free • (269) 782-0985 fax
Notice: Separate application is
required for Summer Semester
Financial Aid Verification (FAV) Form
Part I: Student Information
Full Name: ______________________________________________________Tribal I.D.#__________________
Address:_________________________________City____________________State/Zip____________________
Telephone Number: ____________________________ Email:_________________________________________
College/University: ___________________________________Student I.D.#: ____________________________
I intend to register and take the listed credit hours per term/semester:
Fall 2020: ________Winter 2021: ________Spring 2021:________
I give permission for release of financial information to the Pokagon Band Department of Education.
Student’s Signature: _____________________________________________Date: _____________
Part II: To be completed by your institutions Financial Aid Officer
Education-Related
Expenses
Fall 2020
Winter 2021
or Spring 2021
Student’s Resources Fall 2020
Winter 2021
or Spring 2021
Tuition
Pell Grant
Other Grant
Fees (Health,
Technology, Labs,
Student Activities, etc.)
Indian Tuition Waiver
College Scholarship
Other Scholarships
Other
Total Expenses
Total Resources
Is third-party billing available? ______________
I certify that the financial need and the amounts of institution-administered aid offered the above student to be in
compliance with current applicable rules and regulations governing federal, state, and this institution’s financial
aid policies. Student has filed all appropriate forms needed for Pell Grant including the FAFSA.
Signature, Financial Officer: ___________________________________Date: ____________________________
Printed Name, Financial Officer: _________________________________________________________________
Financial Aid Office Mailing Address: ____________________________________________________________
Telephone: _____________________________________Fax: _________________________________________
Please return this form to the Pokagon Band Department of Education at DOE.HEAP@pokagonband-nsn.gov
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Pokgnek Bodwadmik Financial Aid Verification (FAV) Form Part (Pokagon Band of Potawatomi Indians)

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Completed 20 July 2020

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