Education - COVID-19 College Application

Education - COVID-19 College Application
This application is for Caddo-enrolled College/University students only. Eligible participants will qualify for $1,000.00 to be sent to their school to help defray the cost of attendance. All sections of this application must be completed. If you require assistance filling out this form, please contact Carolyne Botone at cbotone@mycaddonation.com or call (405)656-2344.
Student Name*

First NameLast Name
Student I.D. Number*
Tribal Roll Number*
Last 5 digits only
Email*
example@example.com
Please upload CDIB*

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Physical Address*

Street Address

Street Address Line 2

CityState

Zip Code
Mailing Address

Same as above
Mailing Address*

Street Address

Street Address Line 2

CityState

Zip Code
Name of College/University*
*Must be accredited under the US Department of Education
Financial Aid/Bursar Address*

Street Address

Street Address Line 2

CityState

Zip Code
What level of study are you currently pursuing?*
Has your institution moved to virtual instruction or have you chosen to move to virtual instruction due to the COVID-19 crisis?*

YesNo
Has your institution closed its student dormitories or residences due to the COVID-19 crisis?*

YesNo
If yes, when did your institution close its campus or residences?*
Current living arrangements*

On campusOff campusWith parents or other family members
Have you had a positive COVID-19 test?*

YesNo
Have you been or are you currently in quarantine?*

YesNo
Is there any change in the following for you this semester?*

No ChangeExpendituresFinancial IncomeFinancial AidDebt
If yes, please explain.*
Do you expect any additional expenditures over the remainder of the semester?

Health RelatedRentInternetOther
Please provide a copy of class schedule as recertification of enrollment.*

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Please verify that you are human*
Signature*

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