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Title VI

Native American/Alaska Native Program

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506 FORM

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Federal Program

The Title VI program is part of the United States federal government that is a result of the treaties signed between the United States and the Native American Tribes.

According to the U.S. Department of Education, the purpose of the Title VI Indian Education Program is “to support the efforts of local educational agencies, Indian tribes and organizations, post-secondary institutions, and other entities to meet the unique educational and culturally related academic needs of American Indian and Alaska Native students, so that such students can meet the same challenging academic achievement standards as all other students are expected to meet.”

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506 Form Requirements

Name of student, date of birth, and grade level
Name of the school the student attends
Name of the individual with tribal enrollment (child, child’s parent, or child’s grandparent)
Name of tribe or band for which individual claims membership
The tribe or band recognized by the federal/state
Membership or enrollment number must be included
Name, address, city, state, and zip of the student
Attestation Statement must be signed by parent/guardian
Information about the form can be seen on the back of the it

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506 FORM Continued

Turn in the original completed 506 form to Ami Shah at the District Office.
We have to keep the forms for the district/state in one place
We are required to keep the 506 document for a certain period of time once the student graduates or becomes inactive
Please DO NOT mark anything on Skyward for certification
We will mark the certification in Skyward when the 506 document information has been verified
Administrators will receive an updated list of Native American/Alaska Native students at the beginning of each month
The students who have been verified Native American/Alaska Native will have an X in the certificated column

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��How do we help our Native American/Alaska Native students and families?�

Student advocate
STEM Conference
Tracking grades
Fall Family Fair
Suicide prevention
College Application
Scholarship Seminar
Navajo Government Class
Pow Wows
Letters to families/students

Essay Writing Seminar
Online Navajo Language class - Fall and Spring
Utah seal of bi-literacy
Utah’s Indigenous Day/Month
Backpacks
School supplies
Native American Community Night
Family/Student meetings

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Mentor Schools

Lori Packer 801-567-8178 lori.packer@jordandistrict.org	Elementary Schools
	Antelope Canyon, Aspen, Bastian, Blackridge, Bluffdale, Butterfield Canyon, Columbia, Copper Canyon, Daybreak, Eastlake, Elk Meadows, Falcon Ridge, Foothills, Fox Hollow, Golden Fields, Hayden Peak, Heartland, Herriman, Jordan Hills, Jordan Ridge, Majestic Elementary, Midas Creek, Monte Vista, Mountain Point, Mountain Shadows, Oak Leaf, Ridge View, Riverside, Rocky Peak Virtual, Rosamond, Rose Creek, Silver Crest, South Jordan, Terra Linda, Welby, Westland and Westvale.


Nicholas West 801-567-8343 nicholas.west@jordandistrict.org	Middle Schools
	Copper Mountain, Elk Ridge, Fort Herriman, Hidden Valley, Joel P. Jensen, Kelsey Peak Virtual, Mountain Creek, Oquirrh Hills, South Hills, South Jordan, Sunset Ridge, West Hills, and West Jordan.


Kaitlin Durfey 801-567-8317 kaitlin.durfey@jordandistrict.org	High Schools
	Bingham, Copper HIlls, Herriman, Kings Peak Virtual, Mountain Ridge, Riverton, West Jordan and Valley.

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Resource

Urban Indian Center

120 West 1300 South�Salt Lake City, Utah 84115�Toll Free 866-687-4942�Phone 801-486-4877�FAX 801-486-9943

https://uicsl.org/

�Monday thru Friday: 8:30 AM to 5:00 PM

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OUR DISTRICT WEBSITE

https://compliance.jordandistrict.org/native/

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Contact Information

Ami Shah,Ed.D

801-567-8172

ami.shah@jordanschooldistrict.org

Kaitlin Durfey- Mentor

801-567-8317

kaitlin.durfey@jordanschooldistrict.org

Lori Packer- Mentor

801-567-8178

lori.packer@jordanschooldistrict.org

Nicholas West- Mentor

801-567-8343

nicholas.west@jordandistrict.org

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Thank you!