Scholarship Request, Miss & Teen Candidates

Scholarship Request

Miss Florida and

Miss Florida's Teen Candidates

Miss Candidates = Scholarships remain valid for one year from the date awarded.

Teen Candidates = Scholarships remain valid for one year from the date of your High School Graduation, one year from the date awarded, if already graduated from high school.

All requests must be received prior to the one-year anniversary date.

Reimbursement to an individual is not permitted.

If you have any questions or concerns, please reach out to scholarships@missflorida.org

Today's Date*

Date

Name of Person Completing this form*

First NameLast Name

Name of Candidate*

Mailing Address of Candidate*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Email address of Candidate*

example@example.com

Phone Number of Candidate*

Please enter a valid phone number.

Candidate's Social Security Number (Last Four Digits)*

Candidates Date of Birth*

Date

Title (Local/State) when scholarship was awarded:*

Date scholarship was awarded:*

Date

Amount of scholarship being requested:*

Description (Name) of Scholarships being requested:*

Which type of payment is being requested?*

If Other, please provide details:

TUITION and/or ROOM & BOARD.

Paid Directly to Educational Institution.

TUITION PAYMENT - A current dated detailed tuition statement from your educational institution, NOT A SCREEN SHOT showing:

The effective date of the statement,

Candidate's name,

Candidate's student ID number and/or Account Number,

The name of your educational institution must be printed on the document,

A statement from the educational institution showing an outstanding balance, the name of the educational institution must be present on the statement.

The mailing address, where the check should be mailed.

Transcript (Unofficial transcripts are ok)

ROOM & BOARD PAYMENT - A official tuition statement must show full-time status of 12-credit hrs. Must be living on campus, or in a housing facility operated by the educational institution, housing must show on the tuition statement.

Student ID Number / Account Number*

TUITION STATEMENT and/or ROOM & BOARD STATEMENT Documents:

1. Tuition Statement, issued by within the last 30 days, provided by your Educational Institution showing the following: Your Name, Student ID Number/Account Number, Outstanding Balance (There must be an outstanding balance in order for payment to be issued). 2. Room & Board Statement Attached: A tuition statement, issued within the last 30 days, must be attached showing full-time status of 12 credit hours, Housing must show on the statement. Candidate must be living on campus, or in a housing facility operated by the educational institution.

Upload Transcript (Unofficial transcript is ok)

STUDENT LOAN PAYMENT.

Paid Directly to the Lending Institution.

A current statement, issued within the last 30 days from the lending institution, a copy of the Promissory Note reflecting the name of the candidate as either the primary or secondary payer of the loan.

Upload Promissory Note

Letter from your Local Competition stating all scholarships awarded at the Local Competition have been utilized*

Check to be made payable to:*

Check to mailed to:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

By completing this form and requesting a scholarship payment, it is understood that it may take up to 30 days from the date of submisson to have the payment issued.

Any request submitted for payment due within the 30 days from the date of submission, it is not guaranteed that payment will be received by your educational institute or student loan grantor by the due date.

Signature of Candidate:*