SHAREHOLDER AUTHORIZATION TO RELEASE INFORMATION
Ilisagvik College is an accredited institution and one of 37 tribal colleges nation-wide. As a federally
recognized tribal college, the College receives some of its funding from the federal government and must
provide proof that a certain percentage of the student body is American Indian, Alaska Native, Hawaiian
or part of another First Nations People. Your information serves only to verify that Ilisagvik College
meets that criterion.
Dean of Academic Affairs
By completing the informational items below, I hereby authorize the corporation indicated below to
provide Ilisagvik College with a verification of my enrollment as a shareholder.
Arctic Slope Regional Corporation
Bering Straits Native Corporation
Bristol Bay Native Corporation
Chugach Alaska Corporation
NANA Regional Corporation
Signature of Shareholder and/or Custodian of Record for Minor