Nonpublic School Verification Form for North Dakota Scholarship
Please complete this form to verify the student has met the requirements of the North Dakota Scholarship. For a complete listing of North Dakota Scholarship. For a complete listing of North Dakota Scholarship requirements, please see the North Dakota Scholarship Framework and the North Dakota Scholarship Guidance.
Name of Student
First Name
Last Name
High School Student is Graduating From
Graduation Year
Please check each line below if the student has met the outlined requirements:
Essential Skills (all students)
Student has graduated from high school (include high school transcript)
Student has earned an overall GPA of 3.0 or higher on a 4-point scale (include high school transcript)
The student has completed a nine-week career course or individual career consultation
The student has earned a score of 70% or higher on the North Dakota Civics Exam (NDCC 15.1-21-27)
The student has completed a 4-year rolling plan
Essential Skills (only 4 required in this section)
The student has completed 25 hours of community service
The student was in attendance at least at least 95% of the time in grades 9-12 (excluding school-related)
The student participated in a career exploration experience
The student participated in two years of co-curricular activities
The student participated in two years of extra-curricular activities
The student completed a capstone project
The student completed an online learning course
The student demonstrated competency in 21st Century Skills (the 4 C's)
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Post-Secondary Ready
(Include score reports and/or high school transcripts)
The student has a composite ACT score of 24 or higher, or composite SAT of 1180 or higher. Include ACT or SAT score report if the score is not listed on the high school transcript.
ACT Score:
SAT Score:
Two or more of the seven indicators:
Advanced Placement Course (A, B, C) or (4,3,2)
Dual Credit English or Math Course (A, B, C) or (4, 3, 2)
1 credit Algebra II (A, B, C) or (4, 3, 2)
Score of 3 or higher on an Advanced Placement (AP) exam
Score of 4 or higher on an International Baccalaureate (IB) exam
GPA of 3.0 or higher on a 4-point scale for core course requirements for NDUS admission
3 Fine Arts Courses (A, B, C) or (4, 3, 2)
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Workforce Ready
The student has completed one of the following (include high school transcripts)
4 credits of Career and Technical Education (CTE), with 2 of those credits in the same CTE Coordinated Plan of Study
3 credits of the same world, indigenous, or sign language
A 4-credit educator pathway, as defined by NDCC 15.1-21-02.10 (6)(b)
The student has received a composite ACT score of 24, SAT of 1180, or scores of 5 or higher on all three WorkKeys exams. Enter the scores for the ACT, SAT, or WorkKeys below:
ACT Score:
SAT Score:
WorkKeys - Applied Math:
WorkKeys - Graphic Literacy:
WorkKeys - Workplace Documents:
Two or more of the six indicators:
The student has completed CTE Career Ready Practices
Dual Credit Course (A, B, C) or (4, 3, 2) - include high school transcript
The student has completed a technical assessment or industry credential
The student has completed a 40-hour workplace learning experience
The student has completed a 40-hour Work-based learning experience, as defined by Perkins V
The student has a level 3 or higher score in both reading and math of NDSA - include score report
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Military Ready
The student has an ASVAB score of 50 or higher (31 or higher if the student has completed basic training).
List ASVAB score:
The student has completed the required physical education course (A, B, C) or (1, 2, 3) - include high school transcript
The student has met one set of criteria below:
Two additional indicators from the Post-Secondary or Workforce Ready pathways (Provide accompanying proof if needed (transcript, score report, etc.)
Name of first indicator:
Name of second indicator:
2 credits of Junior Reserve Officer Training Corps (JROTC)- provide transcript
Completion of Phase One of the Cadet Civil Air Patrol Program- provide proof of completion
A 2-credit military coursework pathway, as defined by NDCC 15.1-21-02.10 (6)(c)
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Signature Section
By signing below, I am verifying the above-named student has met all North Dakota Scholarship requirements for which I have initialed. I also agree to provide any additional information to the North Dakota Department of Public Instruction regarding these requirements upon request.
Printed Name of School Official
Full Name
Position
Signature
Date
-
Month
-
Day
Year
Date
Transcript Upload
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Score Report Upload (if applicable)
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Score Report Upload (if applicable)
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Proof of Completion of Cadet Program (if applicable - Military Ready)
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