Request for Scholarship Distribution (2021 & Later)

PLEASE READ THIS INFORMATION IN ITS ENTIRETY – ALL AWARDS ARE PAID ON A FIRST AWARDED, FIRST PAID BASIS

Complete this form in its entirety including the uploading of the required documentation. Per the terms of the Oregon Legacy Scholarship Foundation (OLSF) 501(c)(3) request, scholarships may only be used for current educational expenses and may not be used to reimburse the recipient for any previously paid expenses. (For example, if you pay your tuition bill out of your own pocket the scholarship cannot be used to pay yourself back). Scholarships may be used to pay student loans. Scholarships may be used to purchase electronics required for a course. Please make your request early as most requests will take a minimum of a week to process. (Some will take longer). All checks will be mailed directly to the “Scholarship Recipient Address” you provide on this form. It will be the recipient’s responsibility to forward the payment to the payee on the check. Please email the Oregon Legacy Scholarship Foundation at scholarships@olsf.org if you have questions about completing this form.

Scholarship Terms:

Miss Oregon – Scholarships will expire three years from date of crowning. (Example: if date of crowning 6/19/21 awards will expire on 6/19/24)

All Local Miss candidate awards and Miss Oregon Miss contestant awards – Scholarships will expire two years from the date of program. (Example: program held on 4/11/21 awards expire 4/11/23)

All Local Teen contestant awards and Miss Oregon's Teen contestant awards - Scholarships will expire on October 1st two years after their year of graduation from High School. (Example: if high school graduation is June, 2021 awards expire 10/1/23)

Scholarship Extension: There will be no extension of your scholarship award except in extenuating circumstances. Any extension request must be approved by the Miss Oregon Scholarship Program, OLSF, and the local director, if applicable. If you feel you have extenuating circumstances, please email a written description for review to scholarships@olsf.org. Extension requests must be received at least 30 days rior to the expiration of awards.

SCHOLARSHIP AWARD RECIPIENT INFORMATION

Scholarship Recipient's Name*

First Name & Middle InitialLast Name

Email*

example@example.com

Phone Number*

Address (checks will mailed to recipient for distribution)*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Current Year in College *

i.e. freshman, sophomore, etc.

Total Amount Requested*

Please use cents (100.00)

Are you requesting your scholarships for*

Tuition/FeesStudent Loan RepaymentElectronics (up to $1,000)

Make check payable to*

Student ID for tuition payment & electronics -OR- account number for loan payment*

Comments (if any)

These documents are REQUIRED in order for your request to be accepted.

If you are requesting scholarship funds for tuition/fees, you must upload a tuition bill and current class schedule that are dated within 14 days of this request.

If you are requesting scholarship funds for a student loan, you must upload a loan statement that is dated within 30 days of this request. You must also upload a copy of the degree or certificate earned. (Degree or certificate does NOT have to be awarded within the last 30 days.)

If you are requesting funds for required electronics, you must provide a copy of a tuition bill, a current class schedule and a receipt that are dated within 14 days of this request.

Current Tuition Bill & Class Schedule (date on invoice must be no more than 14 days prior to today's date)*

Browse Files

Electronics Purchase Receipt (must be dated no more than 14 days prior to today's date)*

Browse Files

Student Loan Statement & certificate or degree earned (date on loan statement must be no more than 30 days prior to today's date)*

Browse Files

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