The INDIAN UNIVERSITY OF NORTH AMERICA Summer Program at Crazy Horse, South Dakota

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1 The Summer 2015 University Program Applications must be postmarked by March 30, ADMISSION REQUIREMENTS Admission requirements for the Summer University Program of The INDIAN UNIVERSITY OF NORTH AMERICA, a partnership between Crazy Horse Memorial Foundation and the University of South Dakota, are as follows: Applicants must be years of age when the program commences. Applicants must possess a high school diploma (regular curriculum) before the program commences with a cumulative grade point average or equivalent of 2.5 ACT or SAT scores are required at the time of application. The composite ACT score for regular admission is 21; the SAT score for regular admission is 990. ACT scores below 21 and SAT scores below 990 may be considered for provisional acceptance. Preference is extended to enrolled members of federally recognized tribes, however, the university is open to all qualified students. Applicants must possess a need for the curriculum offered. Completion of a short essay on why the applicant is interested in the program. Applicants, if selected, must complete a telephone interview with the admissions committee. All applicants must complete the admission application and provide accompanying materials postmarked by March 30, Applicants chosen for admission must submit final high school transcripts by June 2, (SAT or ACT scores must be submitted with application) APPLICATION REQUIREMENTS: A complete application package includes the following: The INDIAN UNIVERSITY OF NORTH AMERICA Summer Program at Crazy Horse, South Dakota partnership between Crazy Horse Memorial Foundation and the University of South Dakota 1. Completed application form. (Download a copy of the application at You may complete it online and print it out, and mail it or submit the application to cde@usd.edu. Receipt via will be recognized as signature. 2. Short essay on your reasons for desiring to attend the summer program. 3. Proof of membership in federally-recognized tribe for preference consideration. 4. High school transcript and official college transcripts if previously attended college. Applicants must have successfully completed high school (regular curriculum) to be eligible to begin the program. Official high school transcripts verifying successful completion are required to be submitted by June 2, An unofficial high school transcript is acceptable to attach to this application. 5. ACT or SAT scores and subscores are required. Scores must be submitted with the application. The composite ACT score for regular admission is 21; the SAT score for regular admission is 990. ACT scores below 21 and SAT scores below 990 may be considered for provisional acceptance. 6. One letter of recommendation. Letters should be written by those familiar with your high school work (a high school counselor or core area teacher) or, if you have been out of school for more than two years, by people familiar with your performance in the workplace. 7. Agreement to the Rules of Conduct. (Attached). 8. Students will be contacted if they are chosen for a telephone interview. 9. Demonstration of some degree of post-secondary preparation (examples could include a completed application for admission to a college or university, completed FAFSA, and/or completed applications for various scholarships). Applications that are not complete by the March 30 deadline will not be considered during the priority interview and selection process. Students applying or completing their files after the deadline of March 30, 2015, may be considered for acceptance on a space available basis after priority applicant decisions are finalized. A selection committee comprised of representatives from the University of South Dakota and The Crazy Horse Memorial Foundation will review all applications. Up to thirty-two qualified students and eight alternates will be chosen. All students will be notified in writing, by and telephone of their status. Decisions will be finalized and students will be notified by late April, 2015.

2 Please type or print neatly in black ink. Failure to complete all applicable portions of this application may result in processing delays or make this application impossible to process. Please submit this application with a postmark on or before March 30, 2015, to cde@usd.edu or to USD Continuing and Distance Education, Attn: Crazy Horse Application, 414 E. Clark Street, Vermillion, SD PERSONAL INFORMATION Name: Preferred Name: Last First Middle Social Security Number: Permanent Address: Street City State Zip Code Address: Telephone: Home Phone Cell Phone Work Phone Date of Birth: Sex: Female Male Tribal Affiliation: Enrollment No.: Home Agency & Address: Other Tribal Affiliation: All documentation and application materials should be sent to: Summer Program of the INDIAN UNIVERSITY OF NORTH AMERICA Attn: Crazy Horse Application The University of South Dakota 414 East Clark Street Vermillion, South Dakota cde@usd.edu Page 1

3 EDUCATIONAL INFORMATION Please list the high schools you have attended or are attending (beginning with the most recent). School Name City State Date of Graduation or Expected Date of Graduation School Name City State Date of Graduation or Expected Date of Graduation Cumulative GPA: Please attach your high school transcripts or mail them separately to the University of South Dakota, Summer Program of the INDIAN UNIVERSITY OF NORTH AMERICA, Attn: Crazy Horse Application, 414 E. Clark Street, Vermillion, SD Please list the undergraduate colleges/universities you have attended (beginning with the most recent). School Name City State Dates Attended School Name City State Dates Attended Undergraduate Major: Current Cumulative Undergraduate GPA: Will you plan to return to this college in the fall 2015 term? Yes No Don t Know Please attach your high school transcripts or mail them separately to the University of South Dakota, Summer Program of the INDIAN UNIVERSITY OF NORTH AMERICA, Attn: Crazy Horse Application, 414 E. Clark Street, Vermillion, SD AWARDS AND ACHIEVEMENTS Please list any special awards, achievements, offices held, or memberships which you would like to have considered. (Please attach a separate sheet if necessary.) SPECIAL INTERESTS Please describe your special interests in life. (Please attach a separate sheet if necessary.) Page 2

4 INTERNSHIP PREFERENCE The summer program includes paid internships for accepted students. Please place a check mark by the area you would most like to work. You may check ALL areas that interest you. Welcome Center Ticket Office Tour Guide Restaurant and Snack Shop Gift Shop Participation in the program includes placement in a paid working internship at the monument for hours per week. Your internship hours will be established around your other classes. Each student will be required to work over the weekend. Agree to Rules of Conduct: Please review the attached Rules of Conduct. Only applicants who agree to abide by the established rules of conduct will be considered. I have read and agree to abide by the Rules of Conduct if I am accepted to the program. A check mark indicates agreement. Agree to Statement of Integrity: Please review the Statement of Integrity below. Only applicants who agree to abide by the Statement of Integrity will be considered. We are committed to honesty, fairness, trust, respect, and taking responsibility for our actions. These values are vital to our academic community. As students, faculty, and staff of the University of South Dakota, we make firm our commitment to integrity in word, work, and conduct. We agree to represent all work honestly, to abide by the professional and ethical standards of each discipline, and to insist upon the same commitment from all members of our academic community. I have read and agree to abide by the Statement of Integrity if I am accepted to the program. A check mark indicates agreement PERSONAL STATEMENT AND APPROVAL TO SHARE INFORMATION: I hereby certify that the information supplied by me to the Summer University Program sponsored by Crazy Horse Memorial Foundation and the University of South Dakota is true and correct to the best of my knowledge. My signature below also represents agreement to The Working Internship, the Rules of Conduct and the Statement of Integrity. I also understand that if accepted to the program, I am responsible for submitting proof of required immunization and health insurance information before June 2, 2015, as well as official high school and/or college transcripts. Finally, my signature below authorizes the University of South Dakota to share application information with the Crazy Horse Memorial Foundation and if accepted to the program, I also approve the University of South Dakota to share my academic results with the Crazy Horse Memorial Foundation since they sponsor the program. Name (Printed) Signature Date Not required now, but required by June 2, 2015, if accepted to the program: Official high school transcript. If previously attended college, official transcript of college work. Official means the transcript must be sent directly from the high school or college to the University of South Dakota. The student may hand deliver if envelope is sealed. A 2.5 GPA is required. Proof of tribal membership, if applicable. Proof of immunizations. (Measles, Mumps, Rubella; Hepatitis B immunization & Hepatitis B titer; Varicella/Chicken Pox immunity; DTP/Tdap; Polio; TB Skin Tests or QFT-G Blood Test). Proof of medical insurance and copy of insurance card and ID#. Submission of Emergency Contact Information. Medical prescriptions to assure adequate medication over the 8 week program. Recommitment to agree to Rules of Conduct signed statement. Tracking Authorization Form (FERPA) signed statement. Signed Computer Use Policy Statement. Signed photo release form. Payment of $50.00 Deposit - can pay at check in on June 6. Page 3

5 Professional Conduct Please answer the following questions with Yes or No : (If you answer yes, please elaborate in the space provided) 1. Have you ever been convicted of a crime? Yes No If yes, please describe below. 2. Are you currently on probation through the courts? Yes No If yes, please describe below. Rules of Conduct Agreement to Rules of Conduct By applying to the INDIAN UNIVERSITY OF NORTH AMERICA Summer Program for 2015 at Crazy Horse Memorial, I hereby acknowledge by my signature that I will abide by the Student Handbook and the Rules of Conduct contained therein for the Summer University Program for 2015 and the Student Conduct Policies of the University of South Dakota. If accepted as a student, I understand that it is my responsibility to read, understand and comply with the policies and information contained in this handbook. I further understand the information set forth in this handbook does not constitute a contract, and that revisions to the handbook may occur at any time. Any revisions made, may supersede, or eliminate existing policies. Any such changes will be communicated through official notices. Printed Name of Student Student Signature Date Page 4

6 The INDIAN UNIVERSITY OF NORTH AMERICA Summer Program - Crazy Horse, S.D. Please compose a short essay on why you are interested in attending the Summer University Program. Page 5