TITLE VI STUDENT ELIGIBILITY CERTIFICATION (506 Form)

Download then fill out form according to instructions on second page. If no copy of membership or enrollment number is readily available please include an explanation to why it is unavailable and do not leave this section blank. Once the form is complete either email the form to vgillette@usd259.net or ddomebo@usd259.net or print and mail to the Native American Program at 903 S. Edgmoor, Wichita, KS 67218. Membership cards may be scanned and attached to email or may printed and mailed in with form.

Each student must have an individual form. 

If you have any questions while filling out the 506 form please call 973-4467 or 973-4479.

506 form exp. 2023.pdf, 93.98 KB; (Last Modified on September 17, 2020)