Minnesota Indian Scholarship Online Application

Academic Year 2023-2024 2022-2023

Type of Application
New (never applied)
Renewal (have applied before)

Check all terms you plan to attend
SSII (starts after July 1)
Fall
Winter
Spring
SSI (starts before June 30)

Student Information

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
ALAKAZAR CACOCTDE FLGAHIID ILINIAKS KYLAME MDMAMI MNMSMO MTNENVNH NJNMNYNC NDOHOKOR PARISCSD TNTXUTVT VAWAWVWI WY

Zip Code
(format: 55406 or 554061234)

Marital Status
Single
Married
Other (Divorced, Separated, etc.)
Prefer not to answer

Gender
Male
Female
Prefer not to answer

Social Security Number
(format: 999999999)

Date of Birth
Month January February March April May June July August September October November December Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Year 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933

Phone
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Email Address