Local Scholarship Donor Application 2022-2023

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Please fill out this form. This will help the Local Scholarship Coordinator organize and track scholarship information throughout the academic 2022-2023 school year. Since we are ending our school year earlier than usual, we have had to move up all deadlines. The Local Scholarship Night will take place on Thursday, May 18th, 2023 at 6pm. Thank you for your understanding and we appreciate your collaboration. All donor's applications are due Thursday, November 17th, 2022. Thank you!

Email *

Name of Organization *

Donor's First & Last Name *

Donor's Phone Number *

Donor's Email Address *

Donor's Mailing Address *

City, State, Zip Code *

Name of Scholarship *

Number of Scholarships *

Amount per Scholarship

Presenter's Name *

Presenter's Phone Number

Presenter's Email

Presenter's Mailing Address *

City, State, Zip Code *

Local Scholarship Chair Person may present scholarship on my behalf *

Yes

If we have an actual event in person, whose name should be on the program brochure that we will be handing out at the event? Donor name? Presenter's Name? Please let us know. *

If we are unable hold the physical event itself due to COVID19 and we have to create a video for the recipients again, how would you like to be listed in the credits as a donor (For example, would you prefer the scholarship name or your organization?)

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