Online Survey Software | Qualtrics Survey Solutions

Plateau Scholarship Application

Contact Information

Name

Address

City

State

Postal Code

Email Address

Phone Number

WSU ID Number

Student status:

Incoming Freshman
Current WSU Student, please indicate year in school
Transfer Student, please indicate current institution:
Incoming Graduate Student

Intended major:

Current cumulative GPA:

Have you completed your FAFSA for the 2024-25 school year?

Yes
No

Tribal Affiliation(s):

Documentation

Please provide proof of tribal enrollment or descendancy (i.e. copy of enrollment card, certificate of degree of Indian blood):

Tribal Language Classification:

Sahaptian
Plateau Salishan
Kootenai

Essay Statement

Please submit a written statement of 300-500 words answering the following questions:

1. What are your career goals and why have you selected these goals?

2. How do you plan to finance your education?

3. What have you contributed and how do you hope to contribute in the future to the development and progress of your tribe?

Consent Form

If selected as a Plateau Native American Scholar, I hereby grant permission to Washington State University (WSU) to use of my name and pertinent information including but not limited to tribal affiliation, major, year in school, hometown, and comments from my Plateau Native American application/profile for WSU publication or promotional purposes in any medium including but not limited to print media, newspaper, television, video, motion picture, or website. I grant permission to WSU to release this information to scholarship donors, scholarship trustee, tribal education departments, WSU Native American Advisory Board, Tribal Liaison Newsletter, University communication offices, WSU Foundation, high school counselors, and other entities related to WSU and the Plateau Native American Scholarship program.

I understand that consent to use of my name and pertinent information related to being a Plateau Native American scholarship recipient is not a condition of receiving the Plateau Native American Scholarship and that consent can be refused without any impact in my ability to fully participate in the program. No inducements or promises beyond my acceptance of an opportunity to promote WSU and its programs have been given to me.

Any other use of the above specified information not related to the Plateau Native American Scholarship requires advance permission. I understand that I can revoke this consent at any time upon notice to WSU, at which time I will sign a copy of the denial (below).

Please check the appropriate box below:

Yes
No