Board Scholarship Request Form

Board Scholarship Request Form
Contestant Name*

First NameLast Name
Contestant Phone Number*
Please enter a valid phone number.
Contestant Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Amount Requested
Payee information - make check payable to:*
Attention
School ID number
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
I understand payment may take 45 days to process. I am requesting payment of scholarship at this time.
Signature

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Items required to process scholarship request:

Teen Contestant:
- W9 sign filled out, signed and dated by Teen
Miss Contestant:
- A detailed, current tuition invoice (within 45 days of submittal), reflecting a balance due to the school.
- A copy of the contestant’s confirmed course schedule listing all course names with at least 12 credit hours for undergraduate students and 9 credit hours for graduate students.
- W9 sign filled out, signed and dated by institution
- If for reimbursement of educational expenses, provide receipt for item
File Upload

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