SHPE Scholarship 2024-2025 Fall Documents

ScholarSHPE Award Requirement Form
Congratulations on receiving a SHPE scholarship!

Per your award email, please complete this form to meet the requirements for your fall disbursement.

If you did not receive a SHPE scholarship, do not complete this form as it will not grant you a SHPE scholarship.

The deadline to complete these items is Sunday, August 11th, 2024 at 11:59:59 pm PDT unless otherwise specified in your congratulatory email.
Name*

First NameLast Name
Major*
Fall 2024 University*
Scholarship Received*
Address (Awards can be expected three weeks after completing this form.)*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Media and Liability Release Form (PDF)*

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Completed W-9 (PDF)*

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Official Fall Registration (PDF)*

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Unofficial Transcript (PDF)*

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LinkedIn Profile Link*
Instagram Handle (This will be used to highlight you on our social media where we will highlight recipients on a monthly basis.)
Thank you letter text to SHPE scholarship donor:*
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ScholarSHPE Award Requirement Form