(JOM) Student Grant Program (25-26)

Email
example@example.com
Johnson O’Malley (JOM) Native Student Activities Program

The CITC-Johnson O’Malley Native Student Activities Program provides assistance to meet the educational needs of some Alaska Native and American Indian students enrolled full-time in Preschool - 12th grade in the Anchorage School District (ASD).In accordance with federal regulations, the child must enrolled in Anchorage School District meet at least one of these three criteria:
- at least one-fourth (¼) degree Indian blood descendent of a member of an Indian Tribe, or
- a member of an Indian Tribe. “Indian Tribe” means any federally recognized Tribe and any Alaska Native village or regional corporation under the Alaska Native Claims Settlement Act, or
- have a link to a Tribal member (through descendancy) that is within a certain proximity, meaning the student has at least one parent or grandparent (living or deceased) who is a member of a federally recognized Tribe.
Are the child(ren) that you are applying for in this application enrolled in and attending an Anchorage School District (ASD) school for School Year 2025-26?
⚠️ Eligibility Notice

Only students enrolled and attending an Anchorage School District school for school year 2025-2026 are eligible for CITC's Johnson O'Malley Payments.

If you are seeking other non-JOM assistance, please call 907-793-3600.

Children in Household*
Number of children in application?
Amount Requested ($100 maximum per student from August through July)*
Parent / Guardian Name*

First NameLast Name
SSN*
Guardian Date of Birth*

MonthDayYear
Date
Student Home Address*

Street Address

Street Address Line 2

CityState

Zip Code
Primary Phone*
Please enter a valid phone number.
Parent / Guardian Email*
example@example.com
Statement of Purpose
What types of assistance does your student(s) need? (select up to 2 options)*

CalculatorCap and GownField/School TripGym ClothesInstrument/MusiciPadLaptop/ComputerSchool clothes/winter gearSchool FeesSports GearSchool SuppliesTutoring
How will it help your students' educational goals?*
May we contact you at the end of the school year to discuss how this grant helped you achieve your goals?

YesNo
Attach student’s Certificate of Indian Blood or Tribal Enrolment (if unavailable, you can include Parent’s CIB/tribal enrollment and student’s birth certificate; unfortunately we cannot accept Native Corporation cards). *

The document(s) must demonstrate that the child is at least one-fourth (¼) degree Indian blood descendent of a member of an Indian Tribe, or a member of an Indian Tribe, or have a link to an enrolled tribal member through descendancy meaning that at least one parent or grandparent is a member of a federally recognized tribe. Please submit documents for each child on the application.
Cancelof
Required signatures:
By signing this application, I confirm that I will use Johnson O'Malley Funds for the intended purpose(s) specified above to provide for my student’s educational needs.
Parent / Guardian / Adult Youth (18 years or older) Signature*

Clear
Should be Empty:

Johnson O’Malley (JOM) Native Student Activities Program

Statement of Purpose

Required signatures: