K-12 USIB School Supplies Application Form – Upper Similkameen Indian Band

USIB K-12 School Supplies Allocation Request

***School Supplies Allocation will be sent out the end of the Last week in August and First week of September*** (Please provide a blank voided cheque if you want direct deposit). Email with any questions.

Child's Full Name(Required)
Name of Parents / Guardian(Required)
Phone Number of Parent / Guardian(Required)
Attending Which School(Required)
Grade(Required)
Status Number(Required)
Will your child(ren) be self-identifying as Indigenous?(Required)
Yes
No
Are you requesting a school supplies allocation?(Required)
Yes
No
If requesting a School Supplies Allocation, please provide full name and address for cheque mailing?(Required)
Name of Parent or Guardian(Required)
Email of Parent or Guardian(Required)

Consent(Required)
I agree to the privacy policy.
I agree to USIB using the enclosed information as my application for 2022 K-12 School Supplies Allocation Request.
File for Direct Deposit
Max. file size: 100 MB.
Upload blank cheque if you wish to receive reimbursement via direct deposit.
CAPTCHA
Permission for Release of Student Information to Education Coordinator School District 53 Only
I hereby authorize (School Name) in School District No.53 Okanagan/Similkameen.
To share information, regarding the student indicated above, to the Education Coordinator of Upper Similkameen Indian Band.
Attendance
Individual Education Plan (IEP)

C&C

Chuchuwayha Family Centre

Education

Family Support

Health Department

Housing

IRA

Social Development

C&C

Chuchuwayha Family Centre

Education

Family Support

Health Department

Housing

IRA

Social Development

USIB K-12 School Supplies Allocation Request

USIB

Departments

Members