Diversity & Multicultural Student Services
NDNSS Program Application
2015-2016
Application Deadline: (Mailed, Faxed, or Delivered): To Diversity Multicultural Student Services, @ SMSU 425,
by priority deadline April 30, 2015.
Program Description:
The “Native Development & Networking for Student Success” (NDNSS) program is for first-generation, lowincome, first-time students at Portland State University. This program is designed to help new students
transition to PSU from high school or community college. As a participant in the program you will learn skills
to enhance your success at PSU from staff and student mentors. It will also provide guidance and assistance in
financing your education.
Selected NDNSS Participants will be required to enroll in the DMSS College Success Course Fall 2015,
actively participate in Diversity & Multicultural Student Services community building (social and cultural)
activities and workshops, meet with a designated mentor throughout each term, seek out financial resources for
the academic year, and meet on a regular basis with the NDNSS general advisor.
NOTE: The programing and course content for this program will focus on the American Indian/Alaska
Native student college experience.
Eligibility:
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High school seniors beginning their first term at PSU Fall 2015.
First-generation (neither parent graduated from a 4 year university).
Admitted to Portland State University or currently in the process of admission.
Demonstrated financial need (as determined through FAFSA or financial need statement.
PSU supports equal opportunity in admissions, education, and use of facilities by prohibiting discrimination in
those areas based on race, color, creed or religion, sex, sexual orientation, gender identity, national origin, age,
physical or mental handicap, or veteran status.
Return to: Dean Azule
Native American Student Services
Mail Code: DMSS
Portland State University
PO Box 751
Portland, OR 97207-0751
Fax : 503-725-5462
--------------------------------------------------------------------------------------------------------------------------------Checklist for the Fall Term 2015 Completion:
o I have applied for admission to Portland State or I am currently admitted for Fall 2015.
o A completed application form.
o The required essay
o A copy of my high school unofficial transcript.
Diversity & Multicultural Student Services
NDNSS Program Application
2015-2016
Name: ______________________________________________________________
First
Middle Initial
Last
SID: _______________________________
Mailing Address: _____________________________________________________
Street Address
Telephone: ________/_________________
____________________________________________________________________
City
State
Zip
Cell Phone: ________/________________
_____________________________________________________________________
Primary Email Address
Birth date: ______-______-____________
High School/College Attended: ______________________________________ Graduation Date: _______________ GPA_______
Note: Please provide an unofficial high school/college transcript.
Intended Major(s):_____________________________________
Have you submitted a FAFSA? Yes 
Are you a first generation college student?
Yes 
No 
No  Note, if you are not receiving financial aid please provide a statement of financial need.
Please list scholarships awarded for Fall Term: ____________________________________________________________________
Please list any Tribal grants or scholarships you are expecting: ______________________________________________________
Are you a participant in any support program for Fall Term at PSU? ________ If yes, please list __________________________
Yes/No
(TRiO, L-SAMP, ROADS, etc.)
Are you a participant in the PSU TRiO-Student Support Services Summer Bridge program? Yes  No 
Race/Ethnicity: You are urged to supply this information. However, you may decline without prejudicing y our application in anyway.
Please check any/all that apply.
____I – American Indian or Alaskan Native
Tribal Affiliation________________________
____PI – Pacific Islander
Are you enrolled Y____N____ Are you a Descendent Y___ N___
Please List any additional Ethnicities: ________________________________________________________________
Essay (required) – Print or type your name and student identification number on each page of your essay. Please answer question
thoroughly. Maximum of 400 words for each question.
1.
How has your personal/family/tribal background shaped your educational/career goals? What or who has motivated you to pursue your
college degree? What difficulties have you overcome to get to college?
2.
From the program description on the front page of this application, please explain what component(s) of the NDNSS program you believe will
be the most beneficial to you as a new student at PSU. How will participation in the NDNSS program help enable you to give back to the
Native community?
I hereby authorize Portland State University to furnish copies of my academic record, essay and this application to the NDNSS
program selection committee to review in considering my application. I further authorize release of information for publicity
purposes (if selected for this program).
_______________________________________________________________
Applicant’s Signature
__________/___________/_____________
Date