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Minnesota Office of Higher Education

Minnesota Indian Scholarship Online Application

 
Academic Year

 

Terms of Attendance
SSII (starts after July 1)
Fall
Winter
Spring
SSI (starts before June 30)

Type of Application
New (never applied)
Renewal (applied to program before)

 
First Name:
Middle Initial:
Last Name:
Suffix (Sr., Jr., III, etc.):
Please list ALL names you have used (including maiden names) other than the name provided above:
 
Mailing Address:
 
City, State:
Zip Code: (format: 55406 or 554061234)
 
Permanent Address
(if different from mailing address):
 
City, State:
Zip Code: (format: 55406 or 554061234)
 
Marital Status:
Single
Married
Other (Divorced, Separated, etc.)
Gender:
Male
Female
 
Social Security Number: (format: 999999999)
Date of Birth:
Phone: -
Email Address: