Scholarship Commitment Form
Thank you for your support in sponsoring scholarships because..... Education is one of the most valuable gifts you can give. Please complete this form in its entirety. NOTE: Deadline for submission of form and funding is March 31 for the May Scholarship Award Ceremony.
Scholarship Sponsor Contact Information
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
-
Area Code
Phone Number
Mailing Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Scholarship Information
Have you previously sponsored a scholarship?
*
Yes
No
Will you be awarding a scholarship for the current year?
Yes
No
What is the name of the scholarship you will no longer be sponsoring?
*
Will this be a new (first time) or previously awarded scholarship?
*
New
Previously Awarded
What is the name of your scholarship? (New or Previous)
*
Are you the contact person for your scholarship?
*
Yes
No
Who will be the contact person for the scholarship?
*
First Name
Last Name
What is the contact person's phone number?
*
-
Area Code
Phone Number
What is the contact person's email address?
*
example@example.com
Which academic year(s) will you be awarding your scholarship
*
Current Year Only (August 2023 -June 2024)?
Multi-Year
Multi-Year Pledge (check all that apply)
*
August 2023- June 2024
August 2024- June 2025
August 2025- June 2026
August 2026- June 2027
August 2027- June 2028
What is the full amount of your donation?
*
How will funds be submitted?
One time payment in full
Equal amount annually
Other
Scholarship Selection Criteria
What criteria should the recipient(s) of your scholarship(s) meet? If there are no specific requirements, please insert "USE BCAC SELECTION CRITERIA."
*
How many recipients would you like to be awarded scholarships from your donation annually?
*
How will funds be awarded?
Equal amount each student
Other
Scholarship Recipient Preferences
Have you identified the recipient(s) of your scholarship?
*
Yes, and I will provide the contact information for the recipient(s).
No, I want the Scholarship Committee to select recipient(s).
What is the name of your scholarship recipient?
First Name
Last Name
What is the phone number of your scholarship recipient?
-
Area Code
Phone Number
What is the email address of your scholarship recipient?
example@example.com
Additional Information
Do you want to be a part of the interview/selection process of eligible candidates for your scholarship?
*
Yes
No
In what way or capacity would you like to be involved in the interview or selection process?
*
Who will present the scholarship during the Scholarship Award Ceremony?
*
Me
BCAC Scholarship Committee
Designee
Designee's name
*
First Name
Last Name
Designee's email address
*
example@example.com
Designee's phone number
*
-
Area Code
Phone Number
Please share any additional information, comments, or instructions.
Signature
*
Next Steps
Payment can be made at
deldf.org/scholarship
/.
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