MASF Scholarship Request Submission Form

National Scholarship Award Request Form

Applicable for 2024 and 2025 Miss America National Awards, and 2024 and 2025 Miss America’s Teen National Awards.
Name of Delegate

First NameLast Name
Miss or Miss Teen Title Held at the Time of the Award
Cellular Phone Number of Delegate
Please enter a valid phone number.
Email of Delegate
example@example.com
I hereby certify that I am currently enrolled full-time at an accredited college or university in the United States, that I am in good academic standing, and that I am not under academic or disciplinary probation. I further certify that I have exhausted all other available scholarships and I confirm that no employer or third party is offering tuition assistance as a gift, or grant, or reimbursement. I understand that such assistance must be applied first before any scholarship funds from the Miss America’s Scholarship Foundation (MASF) may be awarded. I acknowledge that I have read, understand, and agree to comply with all MASF policies and requirements. I affirm that all information and documentation submitted with this application is true and complete, and I understand that any falsification or misrepresentation may result in the revocation of scholarship funds and may lead to legal or disciplinary action, including repayment of any funds disbursed.

Miss America’s Scholarship Foundation, Inc. (MASF) awards tuition-only scholarships paid directly to accredited educational institutions on behalf of the recipient and cannot be transferred or utilized for non-educational purposes. Recipients must fulfill all requirements set forth by MASF and the IRS to remain eligible for scholarship disbursement.
Signature

Clear
Enter name of Academic Institution
Enter Degree Program Enrolled
Enter Student ID
Enter Address of Academic Institution

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Enter Email for College Cashier's Office/Student Financial Affairs
example@example.com
Scholarship Award was awarded at:

2024 Miss America2025 Miss America2024 Miss America's Teen2025 Miss America's Teen
Type of Scholarship Award:

Non Finalist AwardFinalist Award - Write in Placement Award Name BelowPreliminary Award - Write in Name of Award BelowOther Award - Write in Name of Award Below
Please list all names of the Award and/or Awards Requested.
Name/Address of School/University and Remittance Information
Name of Parent/Guardian (if delegate is a minor)

First NameLast Name
Email of Parent/Gaurdian (if delegate is a minor)
example@example.com
Cellular Phone Number of Parent/Gaurdian (if delegate is a minor)
Please enter a valid phone number.
Name of State Director

First NameLast Name
Email of State Director
example@example.com
Cellular Phone Number of State Director
Please enter a valid phone number.
File Upload: Delegate Letter Requesting Specific Award - You must name the type of award, the year and the total amount of award you are requesting. Awards are given for TUITION ONLY and you must be currently enrolled in school with full-time credit load. If you are requesting only a portion of funds, or have requested funds previously please include this information in your letter, along with complete contact information.

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File Upload: State Director Letter Confirming State Awards are Exhausted. Must include the amount of State Awards that were both awarded, and claimed, and date claimed. Must also be SIGNED by the Executive State Director.

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File Upload: Course Statement/Schedule (outlining classes for upcoming Semester)

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File Upload: College/University Statement or Invoice (must include amount owed and have a visible reference to the Semester and courses also submitted).

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Date of Graduation from High School (applicable to Teen delegates only).

MonthDayYear
Date
Other File Upload(s):

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Additional notes:
Should be Empty:

National Scholarship Award Request Form