CTF - VERIFICATION OF FULL TIME STATUS FOR SCHOLARSHIP RENEWAL

VERIFICATION OF FULL TIME STATUS FOR SCHOLARSHIP RENEWAL
The Coventry Town Foundation through its Scholarship Program provides funds for resident high school graduates for post-secondary education.
STUDENT'S NAME*
STUDENT'S EMAIL*
example@example.com
SCHOOL NAME*
SCHOOL ADDRESS*
SCHOOL PHONE*
PROGRAM OF STUDY*
I AM A FULL TIME UNDERGRADUATE STUDENT (if No, you are not eligible for a scholarship):*

Yes
WHICH YEAR ARE YOU IN CURRENTLY?*

FRESHMANSOPHOMOREJUNIORSENIOR
WHICH SEMESTER ARE YOU IN CURRENTLY?*

FIRSTSECOND
Anticipated Month & Year of Graduation*
CHECK MAILED TO*
CHECK MAILING ADDRESS*
PHONE*
This application must be submitted online by:
- May 31 prior to school start for Fall Renewal
- November 30 prior to school start for Spring Renewal
Failure to do any of the above will disqualify the applicant for a scholarship.

Note: Falsifying any of the above information will forfeit any future scholarship from.
Signature*

Clear
Date

MonthDayYear
Date
Should be Empty: