LEAF Scholarship Donor Interest Form
Thank you for your interest in donating to our scholarship program. Please take a moment to share a few details with us below. A member of our team will be in contact with you shortly.
Name
*
First Name
Last Name
Organization/Company
*
Enter "self" if you are an individual.
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Mailing Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Tell us about your scholarship donation.
*
Scholarship Donation Amount
*
Enter the total Donation Amount
Please select your donation commitment.
*
This will be a one time donation to be disbursed evenly and awarded to student(s) yearly.
This will be a one time donation to be awarded only once.
This will be a yearly donation to be awarded yearly.
I am unsure of how often I will make a donation at the moment.
Tell us how you would like your donation disbursed.
*
Ex. A yearly disbursement of two $1000 awards over the next 5 years.
Scholarship Name
*
Ex. Stantec Outstanding Student Scholarship, Banfield Memorial Scholarship
Is this a Memorial Scholarship?
*
Yes
No
If this is a Memorial Scholarship, please share details about the individual you would like to honor with this donation.
*
Type N/A if this is not a Memorial Scholarship.
What requirements would you like to recommend for this scholarship?
*
Ex. Awarded to a graduating high school senior who intends to major in Music. Awarded to a graduating student that intends to major in Business.
Would you like to be involved in the selection process?
*
Yes.
No.
Unsure at the moment.
Additional Comments
Submit
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