Dollars for Scholars Scholarship Claim

Dollars for Scholars Scholarship Claim

Please read carefully and complete this form completely.
Student Name*

First NameLast Name
Parent Name*

First NameLast Name
Address (this is where the check will be sent)*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Student E-mail*
example@example.com
Student Mobile Number*
Home / Parent Number*
Student is Enrolled in Classes at:*
(Name of college etc..)
Proof of Enrollment

Proof of enrollment in classes must be a document from the school that you will be attending and demonstrate that you have registered for classes this fall.
Proof of enrollment can be a class schedule or other document that includes this information:

-Your name

-Verifies you have enrolled in classes (acceptance letters and award letters normally do NOT verify enrollment in classes.)

-Name of college, university or school

-Show current school year, date of enrollment or a current date

Screen captures are accepted if they are clear, legible and include the required elements.
Additional Comments
I, the above named student by signing below, certify that the information that I have provided on this form is true.
Student's Signature

Clear
Upload proof of enrollment *

Choose a pdf, jpg, or png file only.
Cancelof
Should be Empty:

Proof of Enrollment