Nya:wëh Sgë:nö’
There are multiple program opportunities and services for your child as they are entering the Salamanca City Central School District through the completion of a 506 form.  Your assistance in gathering this information has allowed for additional supports such as teachers, counselors and social workers, tutoring, language, culture, projects, field trips and guest speakers.  These services and programs have proved to be highly successful and we want to continue to provide them, and more.  In this packet is a 506 form that is requested from the U.S. Department of Education Office of Indian Education. Your completion of this form can assist the district in continuing to receive additional funds to support the various programs listed above for all Native American students.

When filling out this form, please make sure to fill it out in its entirety.  I have explained below.

Student Information

  • Child’s name, DOB, grade, name of school they attend

Tribal Enrollment

  • Name of individual with tribal enrollment (individual named must be a descendant in the first or second generation)

    • If the child is not enrolled, but a parent or grandparent is, their name must be recorded in this part

  • Individual with the tribal membership is the (check one)

    • child, child’s parent, child’s grandparent

  • Name of the Tribe or Band for which individual claims membership

    • example: Seneca, Tonawanda Seneca, Tuscarora, Sioux, Creek, etc

  • The Tribe or Band is (check one)

    • Federally Recognized,

    • State Recognized,

    • Terminated Tribe (Documentation required),

    • Member of an organized Indian group received a grand under the Indian Education Act of 1988 as it was in effect October 19, 1994 (Documentation required)

      • The Hodinosyohnih are State and Federally recognized

      • Proof of enrollment

    • If an enrolled member of the Seneca Nation, please list the enrollment number of the child, child’s parent or the child’s grandparent. If enrolled in another Hodinosyohnih tribe, there is a 6-digit BIA number that is used.  Other tribes have their own enrollment numbers, please provide it for the person enrolled   

  • Name AND address of the tribe or band maintaining enrollment data for the individual listed above

    • This is not your address – if you are an SNI member, the address is 90 Ohiyo Way, Salamanca, NY 14779. Please list the name and address of the tribe for which the individual claims membership

Attestation Statement:

  • Please print your name, sign your name and list your address, email and the date you completed the form