Special Requests

The Special Request Program has changed for the 2020-21 school year.

The purpose of Special Request is to provide extra services for students with special academic needs.

Student Eligibility Requirements:

  • Student must be a Pokagon citizen.
  • Student must have a Release form on file.
  • All applications intended for payment must be received within the current academic year.
  • Special Request Form must be turned in with each request.
  • Supporting documentation must be turned in with the form at the time of request.
  • Multiple requests can be put on the same Special Request form if all documentation is submitted with it.

*all other Special Requests will be reviewed with supporting documentation

This program does not cover the cost of computers or laptops.

Program Funds: Max $500

Time Frame: August 1, 2020  - July 31, 2021

Documents Needed:
Educational Records Release Form, Special Request Application, and any other applicable documentation such as: IEP, 504 Plan, recommendation from medical or educational professional, etcetera.

Call Kristie Bussler at (269) 462-4222, or email EDU@pokagonband-nsn.gov prior to purchasing a device to confirm that it is covered in this program and to start the application process.

The W-9 form is only needed by Finance for direct payments to programs/institutions/services for activities/events. 

PDF icon 2020-2021 Special Request Form233.97 KB
PDF icon W-9 Fillable Form77.65 KB