MMGSP Scholarship Award Request Form

Scholarship Award Request Form

Applicable for Miss Miami Gardens & Miss Golden Glades 2024 scholarship awards.
Name of Scholarship Recipient

First NameLast Name
Scholarship Recipient's Email
example@example.com
Scholarship Recipient's Phone Number
Please enter a valid phone number.
Awards are given ONLY for TUITION and / or STUDENT LOANS. You must be currently enrolled in school with a full-time credit load or have recently completed a degree program.

I certify that as of the date of this request, I am currently enrolled as a full-time student, in an accredited undergraduate program, or a graduate program, leading to an academic degree and that I am submitting this form to request scholarship funds. I further agree I will abide by all the IRS rules for scholarship payments to tuition-only degreed programs, and acknowledge that any attempt to receive funds fraudulently or apply funds in a taxable manner, may result in my forfeiture of any remaining scholarship and possible criminal charges.
Signature

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Name of Academic Institution/ Student Loan Provider
Degree Program Enrolled/ or Completed
Student ID #/ Student Loan Account Number
Address of Academic Institution / Student Loan Provider

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email for College Cashier's Office/Student Financial Affairs
example@example.com
Type of Scholarship Award:

2024 Winner1st Runner Up2nd Runner UpNon Finalist Award
Name & Address of School/University/ Student Loan Provider and Remittance Information:
Name of Parent/Guardian (If scholarship recipient is a minor)

First NameLast Name
Email of Parent/Guardian (If scholarship recipient is a minor)
example@example.com
Phone Number of Parent/Guardian (If scholarship recipient is a minor)
Please enter a valid phone number.
File Upload: Course Statement/Schedule (Outlining classes for upcoming Semester)

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

Cancelof
Should be Empty: