APPLICATION STATUS:

Undergraduate Scholarship:
Graduate Scholarship:
Vocational Scholarship:
Training Scholarship:

APPLICATION INFORMATION:

Last Name: *
First Name: *
M.I.: *
Permanent Address: *
Home Phone: *
-
Cell Phone:
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Student E-mail: *
Last 4 digits of Social Security Number: *
Date of Birth: *
Place of Birth: *

ELIGIBILITY INFORMATION:

Eyak Corporation Native Shareholder:
Shareholder Lineal Descendant:

I am a lineal descendant of this Eyak Corporation Shareholder. (Please Explain)

Relationship:

COLLEGE INFORMATION:

Name of College, University, or School: *
Name of Program/Major: *
Degree Sought: *
Admission Status: *
Financial Aid Office Address:
Financial Aid Office Phone:
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Academic Status: *
Student ID Number:
No. of credits planned:
Student Status: *
Date Semester Begins: *
Date Semester Ends: *
Expected year of graduation or program completion: *

ACADEMIC STATUS:

Current level of education obtained:
Do you currently have any degrees?
If so, what degree(s) and date(s) earned?:

AFFILIATION DISCLOSURE:

Are you a legal descendant of anyone currently serving on the Board of Directors and/or an Executive of Eyak Foundation or TEC Subsidiary? *
Name of Board Member/Executive:
Are you a legal descendant of anyone currently serving on the Board of Trustees of The Eyak Foundation? *
Name of Board Member:

Statement of Correctness, Understanding, and Authorization

Application Information

To the best of my knowledge and belief, I attest that the data contained in this application is true, correct, and complete. I understand that this application does not commit The Eyak Foundation to award an education scholarship or to pay any costs incurred in the submission of this application. I also understand that the action taken by the Board of Directors is final.

Use of Funds

I understand that the proceeds of the education scholarship, if approved, will be used to further my education in the certificate or degree program where I am enrolled as approved by The Eyak Foundation.

Unused Award

I understand that the full amount or any portion thereof is to be refunded to The Eyak Foundation if, for any reason, I am unable to use the award for which I am selected.

Grade Transcripts or Certificate of Completion

I understand that immediately upon completion of the semester, term, or course I must submit a copy of my grade transcripts or certificate of completion to The Eyak Foundation to verify the courses of study during the term for which the award was made.

Eligibility and Probation

I understand that should I not maintain the eligibility or selection criteria of maintaining a minimum GPA of 2.5, I will be put on probation the following semester. Failure to raise the GPA up to a 2.5 that semester will render me ineligible for reapplication of an Eyak Foundation scholarship the next cycle.

Submission of Application

I understand that it is my responsibility - not that of The Eyak Foundation - to obtain the necessary application materials from references, transcript offices, and educational institutions.

Name of Applicant, or parent(s), or grandparent(s) who are Eyak Corporation shareholders: *

Digital Signature & Acceptance of Term of Application

I have read and understand the above "Statement of Correctness, Understanding, and Authorization" and agree to abide by the terms and conditions of the award, if approved.

Applicant Name: *
Date: *
Word Verification: