Scholarship Apply | Indigenia Foundation

Full Legal Name

First Last

Preferred Name (if different)

First

Date of Birth

Your Email Address

Enter Email Confirm Email

Mailing Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Your Phone

Emergency Contact

First Last

Emergency Contact Phone

Please check all that apply and attach supporting documentation:

Certificate of Indian Blood (CIB) from federally recognized tribe

Tribal enrollment certificate

Documentation of membership/association with Tribal Nation or Indigenous community

Canadian First Nation Status Card

Community letter from tribal/Indigenous community leaders verifying cultural affiliation

Cultural affiliation statement with supporting documentation from Indigenous community members

Other acceptable documentation demonstrating Indigenous heritage and community connection

Tribal Affiliation(s)

Community/Nation:

Scholarship APPLICATION