Buchanan Promise Appeal Form

Buchanan Promise Appeal Form

Eligibility, Non-Traditional Training Programs, OR Additional Funds
The Buchanan Promise recognizes that certain extenuating circumstances may make you ineligible for the Buchanan Promise Scholarship. If you believe you should be considered for eligibility due to circumstances beyond your control, please complete this form in full and submit it online. Note: This form is also used to request funding for non-traditional training programs, or to request additional funds.

To help the appeals committee review your case, please include as much detail as possible. Once the Buchanan Promise Appeals Committee has reviewed your appeal, the Program Coordinator will notify you of the decision. The review process typically takes about 30 days from the date of submission.
Student Information
Student Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Student Email
example@example.com
Student Number
Please enter your college ID number.Format: (000) 000-0000.
Year of High School Graduation
Reason For Appeal Request

Note: Items that will not be considered in the Appeal Process include:
- Buchanan School District residency requirements (A Buchanan or Galien zip code does not imply automatic eligibility. Qualified applicants must live within the Buchanan School District boundaries.)

- Graduation and minimum attendance requirements (Qualified applicants must attend Buchanan Community Schools continuously during 9th-12th grade and successfully graduate.)
Eligibility - Residency StatusEligibility: Percentage FundedEligibility - Break in AttendanceNon-traditional Training Programs: Trade School, License, or CertificateTools and Supplies for Non-traditional Training ProgramsAdditional FundsSummer CoursesOther
Program Enrolled In
Program Website URL
Program Contact Name
If applicable
Program Contact Number
Please enter a valid phone number if applicable.Format: (000) 000-0000.
Program Start Date:

MonthDayYear
Program End Date:

MonthDayYear
In 1 or 2 paragraphs, explain in detail the extenuating circumstances that result in you not meeting the Buchanan Promise eligibility criteria OR why you are attending a non-traditional training program. You should also include other information that you want the appeals committee to know (i.e. future career goals, educational plan).*
Attach any relevant documentation that serves as proof of your circumstances (i.e. divorce or separation, information on the non-traditional program you are planning to attend, etc.

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I certify that all of the provided information is true. I understand that all the information I submit with the Appeal Form will be redacted and shared with the Buchanan Promise Executive Committee Board to determine if my appeal will be granted.
Signature*

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Date*

MonthDayYear
Date
Should be Empty:

Buchanan Promise Appeal Form

Student Information

Reason For Appeal Request