Tribal Colleges and Universities Grant Application Form

OMB Control No. 1076-0018
Expiration Date XX/XX/XX

TRIBAL COLLEGES & UNIVERSITIES GRANT APPLICATION FORM INSTRUCTIONS

25 CFR 41.8, Public Law 95-471 (as amended)

DUE DATE: The application is due annually on or before June ___.

Paperwork Reduction Act Statement: This information is collected to meet the reporting requirements. Response to this request is required by Public Law 95-471, as amended. An agency may not request nor sponsor, and a person need not answer, a request for information that does not contain a valid OMB control number. A response to this request is required to obtain or retain a benefit and no action may be taken against the institution’s refusal to supply the information if there is no valid OMB Control Number. The public reporting burden for this form is estimated to average one hour per response, including the time for reviewing instructions, gathering and maintaining data, and completing and reviewing this form. Send comments regarding the burden estimate or any other aspect of this form to Attn: Information Collection Clearance Officer – Indian Affairs, 1001 Indian School Road NW, Suite 229, Albuquerque, New Mexico 87104.

Page One

• Provide the Name of College or University.

• Provide the IRS Number for the Institution.

• Provide the Mailing Address.

• Provide the Accreditation and Type for the College or University.

• Provide the Approving Organization.

• Provide the Name of the Chairperson, Vice Chair, and Board Members.

• Provide the Number of College governing board members by Indian and Non-Indian.

• Provide the Indian Student Count for the previous academic year, by Summer, Fall, Winter, and Spring semesters.

Page Two

• Provide the Number of Degrees Granted for the previous academic term, by Degrees (Master, Bachelor, Associate, Certificate), and Average Class Size, Number of Instructors by Full-time and Part-time.

• Provide the signature of the Chairman of the Board and Institution’s President.

Attachments Required

• Provide the following attachments to the application: Proposed Budget, displaying the total expected operating expenses of education programs and expected revenues from all sources for the academic year.

• Copy of the Institution’s:

  1. Policy Statement, Charter, or Bylaws; and

  2. Catalog of the current curriculum.

• A description of the accounting procedures used for grants received until Pub. L. 95-471.

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