Form 2023 OISHS Application | Oklahoma Council for Indian Education

Which applies to you?*
- I am a school or tribal representative nominating one or more students.
- I am a self-nominating student or parent.

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Who are you nominating on behalf of?*
- Tribe
- School
Nominator Name*
First Last
Nominator Job Title*
Nominator Email*
Enter Email Confirm Email
Nominator Phone Number*
School District*
School SIte*
If your school district has multiple sites, please designate the site your student attends. For example, the Tulsa Public Schools district has eight high school sites (e.g. Booker T. Washington, Central High, etc.), and we need to know which site to make sure the student’s gift arrives in a timely manner.
School Phone Number*
School Mailing Address*
This is where the certificates and cords will be mailed.

Street Address Address Line 2 City State ZIP Code
Nominating Tribe*

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Student

Student Name	School Site	Grade Level	Actions

There are no Students.

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Nominator E-signature: I certify that all of the above information is correct and complete. (type name in box)*

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Parent/Guardian E-signature: I certify that all of the previous information is correct and complete. (type name in box)*

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Student Registrations
Price: $15.00
Student Registration
Price:
How are you paying?*
- Credit Card
- Purchase Order
Purchase order number
If you do not have the purchase order number available at this time, please email the information when you have it to [email protected]
Purchase order upload
Accepted file types: jpg, gif, png, pdf, Max. file size: 10 MB.
Credit Card*
Card Details
Cardholder Name
Total
$0.00

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Comments
Please let us know what you liked, didn't like, or would like to see changed.

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