Winter 2018 TLCEE Program
This is our online scholarship application for the Tribal Learning Community & Educational Exchange (TLCEE) program and will be used for administrative purposes. This application will be held and kept by the TLCEE and Extension programs at UCLA and will be kept confidential. Should the scholarship be approve, information given will be used to register you within the approved scholarship courses. Course will begin on Weds. Jan 17, 2018. Scholarships will be announced on Jan. 16, 2018.
Applicant Name
Last Name *
Your answer
First Name *
Your answer
Middle Initial *
Your answer
Home Address
Address *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Mailing Address
If same as "Home Address" check the box and leave the rest blank
Address
Your answer
City
Your answer
State
Your answer
Zip Code
Your answer
Phone and Email
Phone and Email will be our main methods of contacting you. It is important that we have an email address, this will be used (should the application be accepted) for your registration for the online class.
Home Phone Number (Please include Area Code) *
Your answer
Email Address *
(unique email; use single email for program use)
Your answer
Employer (Optional)
Employer Name
Your answer
City
Your answer
State
Your answer
Zip Code
Your answer
Tribal Affiliation (if any)
Tribal Affiliation
Your answer
Please Select Course(s) you are applying for scholarship
Courses offered Winter 2018:
Please Select Course(s) you maybe interested in future quarters
We will use this to notify you of when these course will be offered in the future.
Additional TLCEE Courses offered in Fall/Spring/Summer
Personal Statement
Please tell us more information about you, why you are choosing to take the TLCEE online course (example: are they part of professional development for your current work in Indian Country, for Tribal development, or furtherance of education)
Please tell us about yourself. Include interests, why you wish to take this (these) courses (example: for professional development, for Tribal development or furtherance of education): *
(500 words)
Your answer
Statement of Anti-Discrimination
TLCEE is committed to an anti-discrimination policy in all of its programs and services. TLCEE is consciously and proactively inclusive of all areas of diversity including, but not limited to, race, ethnicity, color, national origin, ancestry, gender, sexual orientation, religion, age, socioeconomic status, marital status, language, disability, or immigration status.
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