Scholarship Extension Form

Scholarship Extension Request

Please complete this form to request a one year extension in which to redeem your scholarship dollars.
Scholarship recipients are expected to use their MPCSP scholarship funds within one year of the completion of our local competition cycle. We use September 30 as our as our universal date. For example, a candidate who competes and earns a scholarship in our 2025 competition season has until September 30, 2025 to request her scholarship funds. If MPCSP does not receive a scholarship request form or a completed Scholarship Extension Request, from the scholarship recipient within the designated timeline, the scholarship amount will automatically be forfeited. This extension request must be received by us before the September 30th deadline. This should include an explanation of why the request is being made. Requests will be accepted via the online form or can be mailed directly to us. Full scholarship rules are available on the website for further explanation.

If the form is not fully completed we will not be able to process the extension request. Requests can take one to four weeks to process. Please plan accordingly. You will be notified of our decision within that time frame. If you have not received notificiation, it is your responsibility to follow up upon submission of form to verify extension status.

For questions on this form please contact Jennifer Marshall at MPCTreasurer@gmail.com
Candidate Name*

First NameLast Name
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
MissTeen
Year Scholarship was earned*
Enter year you competed and earned scholarship
Please explain in detail the need for the one year extension: *
Please enter full mailing address
Date*

MonthDayYear
Date
Signature*

Clear
Should be Empty:

Scholarship Extension Request