2024 SCHOLARSHIP - Verification & Tuition Bill Submission

RISING SUN REGIONAL FOUNDATION

VERIFICATION OF ENROLLMENT & TUITION BILL SUBMISSION FORM
Scholarship Awardee Name*

First NameLast Name
Email - PERSONAL, not your school email.*
example@example.com
Cell Number*
Please enter a valid phone number.
Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent(s) or Guardian(s) Name(s)*

First NameLast Name
Parent/Guardian Phone Number*
Please enter a valid phone number.
Parent/Guardian Email*
example@example.com
Name of Postsecondary College, University, or Training Institution*
Current Course of Study*
I am a 2024 Graduating Senior from*
Upload proof of your acceptance and enrollment in a college, university or other postsecondary training institution*

Cancelof
Upload a copy of your tuition bill*

Cancelof
Please review carefully before submitting.

I understand that by submitting this signed document, I attest that the information provided is true and accurate.

1. I agree to utilize this grant at the institution so stated by me in this application or I will consult with the Rising Sun Regional Foundation regarding any proposed change.

3. I understand that I must use said funds within one calendar year from the date of the award or any unused balance will be forfeited.

4. I understand that the award may be used for tuition, books, room and board, or student fees, and that I will first apply said funds toward any outstanding tuition and book expenses.

5. I hereby specifically waive any confidentiality which might otherwise be involved and freely consent to said institution furnishing any and all scholastic information regarding me which it may at any time have in its file or on record.

6. I hereby consent to receiving communications from the Rising Sun Regional Foundation about my scholarship award via email and/or text message.
Date*

MonthDayYear
Date
Signature*

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RISING SUN REGIONAL FOUNDATION