Title VI 506 Form
Buffalo Public Schools
Native American Resource Program, Title VI
Native American Magnet School #19
97 W. Delavan Ave., Buffalo, NY 14213
The Buffalo Public Schools receives additional funding through the U.S. Department of Education: Office of Indian Education Title VI grant which serves to meet the unique educational and culturally related academic needs of Native American and Alaskan Natives. Through the Title VI grant, we are able to ensure that Native American and Alaskan Native students gain knowledge and understanding of Native communities, languages, histories, traditions and cultures.
To obtain an accurate count of our district’s Native American and Alaskan Native student population, we would like to request your assistance by completing the attached Title VI ED 506 Indian Student Eligibility Certification Form (form can be found below). This form serves as the official record of eligibility for students included on the Title VI Indian Education grant. Please note, you are not required to complete or submit this form. However, your child/children cannot be counted for funding under this program if you choose not to submit the attached 506 form.
The 506 form only needs to be completed once and it will remain on file while your child/children are enrolled in school. A separate form must be fully completed for each child.
This form must include all of the following information:
- Name of child and date of birth;
- School name and current grade;
- Name of Tribe, band of which the student, parent or grandparent is a member (Individual MUST be a descendent in the first or second generation, i.e. student, parent or grandparent);
- Name of individual with tribal membership;
- Whether the individual named is the child, the child’s parent, or the child’s grandparent;
- Proof of enrollment/membership, as defined by Tribe or band identified on form, as defined by Tribe, which can be either: Membership or enrollment number, OR other evidence establishing the membership;
- Name and address of the organization that maintains updated and accurate membership data for the Tribe or band for which the individual is a member;
- The name, address and email of the parent or legal guardian of the child;
- Signature of the parent or legal guardian of the child;
- Date the 506 Form was completed.
Please complete form below and return to:
Buffalo Public Schools
Native American Resource Program
Attn: Charity Hill
425 South Park Ave.
Buffalo, NY 14204
Although we do not have direct contact with all students enrolled in the Buffalo Public Schools, we are here to assist all Native American families. If you have any questions, please email Charity Hill (Native American Program Coordinator) at email@example.com or call at 816-3371.
Native American Resource Program, Title VI Staff