2024 State Miss Scholarship Request

2024 STATE SCHOLARSHIP REQUEST
Deadline: June 22, 2025
Extendible Upon Request

Please use this form to requests scholarship dollars earned at the 2024 Miss Wisconsin state competition. This form should not be used for requesting local scholarships.

Please review this entire form thoroughly before completing - to ensure you have all pieces of required information. We will not be able to process any requests that are missing ANY INFORMATION. Unfortunately, this is not flexible - so please follow the instructions precisely. If the request is incomplete, receipt of your scholarship WILL BE DELAYED.

If you have any questions, please email scholarships@misswisconsin.com

Please review the SCHOLARSHIP RULES AND REGULATIONS

Contestant Name*

First NameLast Name

Contestant Email*

example@example.com

Contestant Phone Number*

Area CodePhone Number

Contestant Birthdate*

Date

Local Title at 2024 State Competition*

Local Organization Email Address*

example@example.com

Last 4 Digits of SSN*

College Name*

College Major*

Candidate Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Prior to requesting and receiving any scholarships from the State Organization, the Candidate must have received all LOCAL scholarships.

Please have your Local Director sign this Local Scholarship Request and Affidavit and upload here to confirm that your local level scholarships for 2023 are fully paid.

Upload Signed Affidavit*

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2024 Scholarship Award Earned*

2024 Scholarship Award Earned

Total Scholarship Amount Requested*

This will auto-calculate based on your selections above

Make Check Payable To:*

MUST BE A SCHOOL or LOAN COMPANY. Checks WILL NOT be written to individuals.

Student ID or Loan Payment Account #*

As shown on tuition bill or loan bill

Payment Address*

Must be sent to school or loan servicing provider.

Type of Payment*

Tuition/Room & Board (payable to a SCHOOL - no personal reimbursements)Educational Loan (payable to a LOAN PROVIDER - no personal reimbursements)

Upload Promissory Note (required only for loan payment)

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Upload Transcript (unofficial is acceptable)*

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Upload Tuition or Loan Statement*

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Must be dated within the last THIRTY (30) DAYS and must show an amount due that is GREATER THAN or equal to the amount being requested

Date of Attached Statement (must be printed on statement)*

Date

I confirm that today's date is within 30 days of the date on the Attached Statement.*

Confirmed

Amount Due to school or loan as shown on Attached Statement*

I confirm that the amount I am requesting is LESS than or EQUAL to the amount due on the Attached Statement*

Confirmed

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